New Italian research adds to evidence that people with the immune condition called sarcoidosis often suffer from mental health problems, especially depression.

In the new depression study, researchers led by Arianna Goracci, M.D., examined 80 consecutive sarcoidosis patients who sought treatment at the University of Siena from November 2004 to September 2005. They found that 44 percent of the 80 sarcoidosis patients showed signs of mental illness. One in four had depression.

It is not clear if the higher rate of mental illness in the patients is due to sarcoidosis itself or to the strain of living with a chronic disease. Instead, it is likely that both factors are at play, said Dr. Marc Judson, director of the Sarcoidosis Center at the Medical University of South Carolina.

I think that some of it relates to it being a chronic illness and some of it is related to the mechanism of the disease,” said Judson, who is familiar with the study findings. He co-authored an earlier study that found 60 percent of American sarcoidosis patients suffered from depression.

Tens of thousands of Americans suffer from sarcoidosis, according to the National Heart, Lung, and Blood Institute. African-Americans are especially susceptible to sarcoidosis; comedian Bernie Mac, who died last month, had the condition.In people with sarcoidosis, clumps of immune cells appear in organs like the lungs or lymph nodes. The clumps can cause organs to stop working properly. The main treatment is the steroid drug prednisone, which calms the immune system, but can cause a variety of side effects.

The study findings appear in the September-October 2008 issue of the journal General Hospital Psychiatry.

Beside depression, present patients in the study suffered from panic disorder (6 percent), bipolar disorder (6 percent) generalized anxiety (5 percent) and obsessive-compulsive disorder (1 percent).

Daniel McNally, chief of pulmonary and critical care medicine at the University of Connecticut Health Center, said the value of the study is limited because it looks at a subgroup of people with more severe cases of sarcoidosis.

The main findings are not surprising, McNally said. “People who are sick have psychiatric issues, anxiety and poor quality of life. What did you expect?”
General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177.

Goracci A, et al. Quality of life, anxiety and depression in Sarcoidosis.

About Depression 

Depression is a mental health disorder that can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is more than a passing mood.

Depressive disorders come in different forms. Three of the most common are Major Depression, Dysthymia, and Bipolar Disorder. Even within these types of depression there are variations in the number of symptoms, their severity, and persistence.

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight loss or overeating and weight gain
• Thoughts of death or suicide; suicide attempts
• Restlessness, irritability
• Loss of interest or pleasure in hobbies and activities that were once enjoyed
• Reduction in sex drive
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain