Association between depression and anxiety with skin and musculoskeletal clinical phenotypes in systemic lupus erythematosus

Abstract

Objectives To study the clinical phenotypes, determined based on cumulative disease activity manifestations, and sociodemographic factors associated with depression and anxiety in SLE. Methods Patients attending a single centre were assessed for depression and anxiety. SLE clinical phenotypes were based on the organ systems of cumulative 10-year SLE Disease Activity Index 2000 (SLEDAI-2K), prior to visit. Multivariable logistic regression analyses for depression, anxiety, and coexisting anxiety and depression were performed to study associated SLE clinical phenotypes and other factors. Results Among 341 patients, the prevalence of anxiety and depression was 34% and 27%, respectively, while 21% had coexisting anxiety and depression. Patients with skin involvement had significantly higher likelihood of anxiety compared with patients with no skin involvement [adjusted odds ratio (aOR) = 1.8; 95% CI: 1.1, 3.0]. Patients with skin involvement also had higher likelihood of having coexisting anxiety and depression (aOR = 2.0, 95% CI: 1.2, 3.9). Patients with musculoskeletal (MSK) (aOR = 1.9; 95% CI: 1.1, 3.5) and skin system (aOR = 1.8; 95% CI: 1.04, 3.2) involvement had higher likelihood of depression compared with patients without skin or musculoskeletal involvement. Employment status and fibromyalgia at the time of the visit, and inception status were significantly associated with anxiety, depression, and coexisting anxiety and depression, respectively. Conclusion SLE clinical phenotypes, specifically skin or MSK systems, along with fibromyalgia, employment and shorter disease duration were associated with anxiety or depression. Routine patient screening, especially among patients with shorter disease duration, for these associations may facilitate the diagnosis of these mental health disorders, and allow for more timely diagnosis.

Relevant Characteristics Analysis Using Natural Language Processing and Machine Learning Based on Phenotypes and T-Cell Subsets in Systemic Lupus Erythematosus Patients With Anxiety

“…Among inflammatory phenotypes characterizing patients with depression and anxiety, the patients have autoimmune diseases to be at high risk (4,32,33). In particular, SLE patients with anxiety and depression have specificity disease phenotypes that involve multiple organs (34). This supports one point at least, that in SLE patients with anxiety, the management of depression, fatigue, and anxiety may not only be a separate entity but a whole way of looking at treatment better.…”

Relationship between Interleukin 6 Serum Levels and Degree of Depression in Systemic Lupus Erythematosus Patients Internal Disease in Dr. Moh Hoesin Palembang

“…However, Eldeiry found a significant association in female LES patients who experienced skin discoloration compared to those who did not. 27 Jordan et al also found reduced quality of life in LES sufferers which led them to become depressed, so that mental assistance from family and those around them is urgently needed. 28 In this study, the number of research subjects was Correlation analysis was used to assess the strength of correlation and its direction.…”

Dual trajectories of fatigue and disease activity in an inception cohort of adults with systemic lupus erythematosus over 10 years

“…27 These include: skin (skin rash, alopecia and mucosal ulcers), central nervous system (seizure, psychosis, organic brain syndrome, cranial nerve involvement, visual disturbance, lupus headache, cerebrovascular accident), vasculitis, musculoskeletal (arthritis and myositis), renal (proteinuria, hematuria, pyuria and urinary casts), serosal (pleuritis and pericarditis), hematological (leukopenia and thrombocytopenia), immunological (low complements and positive anti-dsDNA antibodies), and constitutional (fever). 28 Ten-year cumulative organ damage was quantified using Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index (SDI) which were ascertained by 12 organ-systems. 25,29…”

“…31 Ten-year cumulative organ involvement and damage by organ system, glucocorticoid use and presence of fibromyalgia (diagnosed based on the ACR 1990 fibromyalgia classification criteria). 28 Cumulative glucocorticoid use was calculated by determining the start and end date of each dose range, multiplying the time interval by the dose received and subsequently finding the sum dose of treatment periods.…”