E115 Screening for depression and anxiety disorders in patients with systemic sclerosis: a high burden of unmet need and clinical utility of abbreviated PHQ-2 and GAD-2 questionnaires

Background/Aims Research into the psychological impacts of systemic sclerosis (SSc) is limited, although higher rates of anxiety and depression have been reported compared to the general population. We aimed to evaluate the implementation of routine screening for mental health difficulties in patients with SSc into our clinical practice and share our experience. Specific aims were to: 1) determine the prevalence of anxiety and depression symptoms, and 2) examine the performance of abbreviated questionnaires, in patients with SSc. Methods Patients with SSc attending their annual review at Salford Royal Hospital (a UK tertiary referral centre for SSc) completed the Patient Health Questionnaire (PHQ)-9 and Generalised Anxiety Disorder (GAD)-7, which are screening questionnaires for depression and anxiety, respectively. The first two questions from these questionnaires constitute the PHQ-2 and GAD-2, which are shorter, screening measures for anxiety and low mood. Results Between February and September 2025, 131 questionnaires were administered and 89 (69%) patients completed both. The mean age was 61 years, and the majority were female sex (78%). Most (81%) had the limited cutaneous subset of SSc. Median (IQR) disease and RP duration was 11 (7-16) and 16 (11-30) years, respectively. Around half (44%) had a history of digital ulcers, and with interstitial lung disease and pulmonary hypertension in 33% and 6% respectively. For the PHQ-9, one-third had either moderate (n = 28) or severe (n = 5) mood symptoms (mild = 33, low = 33). For the GAD-7, one-quarter had either moderate (n = 14) or severe (n = 11) anxiety symptoms (mild = 14, low = 50). There was a very high correlation between PHQ-9/PHQ-2 and GAD-7/GAD-2 scoring: PHQ-9 vs PHQ-2: ICC (95% confidence interval) = 0.89 (0.84-0.93, p < 0.001. GAD-7 vs GAD-2: ICC (95% confidence interval) = 0.95 (0.92-0.96), p < 0.001. Conclusion Depressive and anxiety symptoms are common in patients with SSc and can be severe. Our data highlight that the structured (and routine) screening of patients with SSc is helpful to allow earlier detection of difficulties, and can facilitate signposting to appropriate services. The abbreviated PHQ-2 and GAD-2 questionnaires provide highly comparable content, further reducing patient time and effort required for completion.