Social appearance anxiety and its associations with anxiety, depressive symptoms, and health-related quality of life in systemic sclerosis: a cross-sectional study.

INTRODUCTION/

OBJECTIVES

This study aimed to evaluate social appearance anxiety in patients with systemic sclerosis compared with healthy controls and to examine its associations with anxiety, depressive symptoms, health-related quality of life, and disease-related clinical features.

METHOD: This cross-sectional study included 71 patients with systemic sclerosis and 38 healthy controls. Social appearance anxiety was assessed using the Social Appearance Anxiety Scale. Anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale, and health-related quality of life was assessed using the Short Form-36. Disease-related variables, including modified Rodnan skin score and EUSTAR disease activity index, were recorded.

RESULTS

Patients with systemic sclerosis had higher Social Appearance Anxiety Scale scores than healthy controls [32.0 (21.0-51.5) vs. 19.0 (16.25-34.0); p = 0.003]. Anxiety and depressive symptom scores were also higher in patients with systemic sclerosis. In systemic sclerosis, social appearance anxiety correlated positively with anxiety symptoms and negatively with several health-related quality-of-life domains. No significant association was observed between social appearance anxiety and modified Rodnan skin score or EUSTAR disease activity index.

CONCLUSIONS

Social appearance anxiety is increased in systemic sclerosis and is associated with psychological distress and impaired health-related quality of life rather than conventional disease activity or skin thickness measures. These findings support incorporating psychosocial assessment into routine systemic sclerosis care. Key Points • Patients with systemic sclerosis had higher social appearance anxiety than healthy controls. • Social appearance anxiety was associated with anxiety symptoms and impaired health-related quality of life. • Social appearance anxiety was not significantly associated with skin thickness or EUSTAR disease activity. • Psychosocial assessment may provide clinically relevant information in systemic sclerosis care.