Author(s): Karol DE, CriscioneSchreiber LG, Lin M, Clowse ME
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Abstract BACKGROUND: Depressive symptoms affect anywhere from 11\% to 71\% of patients with systemic lupus erythematosus (SLE), which may be related to SLE disease activity, other clinical variables, or sociodemographic factors. OBJECTIVE: We aimed to measure the rate of depressive symptoms in our cohort of patients with SLE and to identify modifiable factors associated with depressive symptoms. METHODS: Patients in our university-based SLE registry completed the Beck Depression Inventory-II (BDI-II), pain scores, and demographic information. Disease activity was measured using the physician's global assessment (PGA) and Selena-SLE disease activity index (Selena-systemic lupus erythematosus disease activity index (SLEDAI)). Patients were identified as having moderate or severe depressive symptoms (BDI-II ≥ 18) or not (BDI-II < 18). Nonparametric tests and χ(2) tests were used as appropriate to compare variables between groups. RESULTS: Fifty-three of 127 people (41.7\%) were identified as having moderate or severe depressive symptoms, which were associated with higher pain levels and lower self-reported of current health status. Patients with moderate or severe depressive symptoms were more likely (49\%) than those with no or mild depressive symptoms (18\%) to have lupus arthritis (P < 0.01). Of the 53 patients with moderate or severe depressive symptoms, only 26 (49.0\%) were prescribed antidepressants, and only 8/53 patients (15.0\%) were prescribed the maximum dose of antidepressant. CONCLUSIONS: This study identified moderate or severe depressive symptoms in 41.7\% of our cohort of patients with SLE. The most significant variable associated with these symptoms was pain; improved treatment of pain, and in particular from lupus arthritis, may result in alleviation of depressive symptoms in patients with SLE. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
This article was published in Psychosomatics
and referenced in Rheumatology: Current Research