PSYCHOSOCIAL ASPECTS-CHART
| Aspect |
Multiple Sclerosis (MS) |
Sjogren's Syndrome (SS) |
Scleroderma (SSC) |
Systemic Lupus Ereth. (SLE) |
| Women Diagnosed |
75% |
90% |
80% |
90% |
| Cognitive |
40-80%; mostly mild-mod.,
short-term memory word finding difficulty. |
Memory, attention or severe
Alzheimer's 2/3-3/4 cognitive or psychological problems. |
N/A |
OMS, seizures, stroke |
| Psychiatric/Behavioral/CNS |
Primarily depressive. |
Mild or moderate-depression,
hypomania, severe depression- 10% |
Possible organic, inflammatory
cause of depressive syndrome |
Personality disorders psychoses,
seizures, migraine, frightening hallucinations, depression. |
| Variable Course |
Very variable- diagnosis usually
in early adulthood. |
Most women diagnosed
postmenopause. |
Very variable- local mild skin
problem to death systemic- CREST mild form. |
Very variable. |
| Genetic |
30% identical twins 5%-other
first degree relatives. |
Children of mothers with SS-
serious heart defects possible. |
Hereditary aspect possible- needs
more exploration. |
30%- identical twins, 5%- other
first degree relatives. |
| Rx |
Interferon A&B Copolymer
Symptomatic Rx. |
Moisture replacement, NSAIDS,
estrogen replacement postmenopause. |
Steroids not effective D-
penicillamine, cytoxan, methotrexate, colchicine, ASA. |
Avoid infections, sun, steroids. |
| Fatigue |
Most common MS symptom. |
Debilitating fatigue late AM
early PM, or early AM. |
Common. |
Very common, often indicates
flare-up is coming; present- almost all- also malaise and fever. |
| Pain |
Neurologic. |
Similar to RA or SLE. |
Painful joints. |
Joint pain. |
| Reproductive |
Postpartum increase in disease
activity |
N/A |
May be delay in conception or
infertility, low birth weight, ill health in pregnancy "all in your head." |
Postpartum increase in flare-ups;
problems during pregnancy, if renal disease is present. Menses may cease during flare-ups
affecting fertility. Spontaneous abortions and prematurity. |
| Diagnosis |
Maybe difficult, history, neuro
exam, MRI, etc. |
Difficult. |
Difficult. |
Difficult sometimes- Raynaud's +
edema + hard skin. |
| Sexual Dysfunction |
Common- decreased vaginal
sensation & lubrication |
Vaginal dryness dyspareunia. |
Vaginal lubrication decreased. |
Vaginal lubrication decreased-
many 2° problems- pain, depression. |
| Prevalence |
250-350,000 |
50,000 |
300,000- combined forms 700,000. |
50,000 diffuse. |
| Other |
Loveland study- women labeled
hysterical, emotional. |
N/A |
Alopecia, altered pigmentation,
RA, lung, cardiac, liver. |
Alopecia, fever, rashes,
photosensitivity, arthritis, pleurisy, symptoms worse between ovulation and menses. |
| Features |
Fatigue; sensory and mobility
impairment, visual dysfunction, bladder, bowel, sexual dysfunction. |
"Chipmunk faces" 1°
moisture decreased 2° connective tissue also joint swelling. |
Skin hardening. Onset often in
40s. No racial predilection. |
Onset 13-40 yrs, 3x more common
among Blacks than Caucasians Arthralgias- most common-often symmetric. |