Depression and Quality of Life in Patients with Systemic Lupus Erythematosus

Abstract

Objective. The objective of this study is to examine the prevalence of depression and its related factors including quality of life, brain-derived neurotrophic factor (BDNF), and vitamin D in patients with systemic lupus erythematosus (SLE). Methods. Depression was assessed using the center for epidemiologic studies depression (CES-D) scale. Disease activity, disease-related organ damage, the EuroQol-5 dimensions (EQ-5D), sociodemographic features, and laboratory tests including serum vitamin D level were surveyed. Serum BDNF was measured using an enzyme-linked immunosorbent assay. Results. Depression was observed in 22.8% of 180 SLE patients (n=41). Patients with marital status of single/divorced/separated/widowed, a higher patient global assessment (PGA) score, and extreme pain/discomfort showed significant association with depression. The EQ-5D index showed negative correlation with CES-D score (r=−0.56, p＜0.05). In each EQ-5D dimension, depression showed significant association with moderate to severe problems in self-care and usual activities, and extreme pain/discomfort. Serum BDNF levels were not associated with depression (p=0.75) but associated with SLE disease activity index (SLEDAI; r=−0.21, p＜0.05). Serum vitamin D levels were not associated with depression (p=0.60) but showed negative correlation with SLEDAI (r=−0.23, p＜0.05) and mean glucocorticoid dose over the previous 3 months (r=−0.21, p＜0.05) after adjustment for use of vitamin D supplement. Conclusion. Depression was prevalent in patients with SLE and was associated with low quality of life, and a higher PGA but not with SLEDAI. Serum BDNF and vitamin D levels were not associated with depression but showed negative correlation with SLEDAI. (J Rheum Dis 2015;22:346-355)

Prevalence and biopsychosocial factors associated with depressive symptoms among patients living with systemic lupus erythematosus in clinical settings in urban Thailand

“…On the other hand, the observation in the multivariable analysis showed extreme pain, severe fatigue, and high dosage of steroid use were strongly interwoven in physical and psychiatric disorders among patients with SLE [27,29,38]. These factors and depressive symptoms share norepinephrine or serotonin neurotransmitter pathway pathology in the central nervous system that can provoke manifestations of physiological illness.…”

“…The sample size was calculated by G*Power version 3.1.9.7 program and based on the results of a study, an independent pain variable by Chang et al [38] depression and quality of life in patients with systemic lupus erythematosus: odd = 3.477, two tails x distribution equal to the binomial, confidence level in test α = 0.05, power of test = 0.80, the relationship between other variables (R2 other X) = 0, and X parm π = 0.638, at least 168 participants were needed. Adding 10.0% to account for error during the study, at least 185 participants were required for the analysis.…”

“…Poor financial status or insufficiency of household income is a factor associated with depressive symptoms in patients with SLE [38]. After 5 years with SLE, 15 to 40% of patients had lost their jobs, and after 10 or 15 years, 36 and 52% were jobless [16,39].…”

Prevalence and biopsychosocial factors associated with depressive symptoms among patients living with systemic lupus erythematosus in clinical settings in urban Thailand

“…On the other hand, the observation in the multivariable analysis showed extreme pain, severe fatigue, and high dosage of steroid use were strongly interwoven in physical and psychiatric disorders among patients with SLE (19,21,30). Considering those factors and depressive symptoms altogether share norepinephrine or serotonin neurotransmitter pathway pathology in the central nervous system that can provoke visible and invisible manifestations of physiological illness.…”

“…Poor nancial status or insu ciency of household income is a factor associated with depressive symptoms in patients with SLE (30). After ve years with SLE, 15 to 40% of patients had lost their jobs.…”