Self-Reported Anxiety and Depression in a Monocentric Cohort of Patients With Systemic Lupus Erythematosus: Analysis of Prevalence, Main Determinants, and Impact on Quality of Life

Elefante, Elena; Tani, Chiara; Stagnaro, Chiara; Signorini, Viola; Lenzi, Beatrice; Zucchi, Dina; Trentin, Francesca; Carli, Linda; Ferro, Francesco; Mosca, Marta

doi:10.3389/fmed.2022.859840

Cited by 12 publications

(10 citation statements)

References 29 publications

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“…Notable SLE-specific factors, as reported in the literature, encompass pain and fatigue, heightened disease activity, and the involvement of the musculoskeletal and skin systems [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

One-Year Outcomes for Depression and Anxiety in SLE Patients

Duca,

Roman,

Ifteni

et al. 2024

Biomedicines

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Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) is a severe form of SLE involving the nervous system, resulting in neurological and psychiatric symptoms. Although research has shown that SLE patients often suffer from cognitive impairments, depression, and anxiety, there are no specialized guidelines for psychiatric assessment and treatment. This study aimed to investigate the progression of neuropsychiatric symptoms in SLE patients, explicitly focusing on anxiety and depression, over a year. It also aimed to identify potential biomarkers linked to NPSLE and explore the connection between NPSLE and the overall progression of SLE. Our research involved a longitudinal study with 65 adults diagnosed with SLE. Participants underwent various physical, biochemical, and serological tests and were assessed using disease activity indexes like BILAG-2004 and SLEDAI-2K. Participants also underwent psychological assessments using the Hamilton Anxiety and Depression Rating Scales. The study did not find any significant impact of antidepressant therapy on the evolution of anxiety and depression among participants. However, medications like Methotrexate and Plaquenil showed a substantial reduction in these symptoms. Moreover, anxiolytic therapy seems to influence depression in SLE patients. The study also noted that anxiety levels tend to increase over time but are not directly associated with SLE activity. This study concludes that although specific SLE medications can affect the level of anxiety and depression, the overall effectiveness of neuropsychiatric therapy in managing these symptoms is limited. The findings suggest that further research into the tailored management of NPSLE symptoms and a deeper understanding of the disease’s psychiatric aspects are needed.

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Section: Discussionmentioning

confidence: 99%

One-Year Outcomes for Depression and Anxiety in SLE Patients

Duca,

Roman,

Ifteni

et al. 2024

Biomedicines

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“…Depression can occur for a variety of reasons, such as stress, personality, loneliness, family history, illness, and alcohol or drug use. The most reported SLE-specific factors including pain and fatigue ( Monahan et al, 2021 ), increased disease activity ( Knight et al, 2018 ), and musculoskeletal and skin system involvement ( Elefante et al, 2022 ) ( Eldeiry et al, 2020 ). Most of them could influence modifiable factors, such as self-esteem and strain, subsequently.…”

Section: Discussionmentioning

confidence: 99%

Depression in systemic lupus erythematosus: Modifiable or inheritable? a two-sample mendelian randomization study

Chen

2022

Front. Genet.

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Observational studies have found increased incidence of depression, the leading cause of disability worldwide, in patients with systemic lupus erythematosus (SLE). However, it is not clear whether the association was genetically inheritable or caused by modifiable risk factors, such as socioeconomic factors. We investigated the causal relationship between genetically predicted SLE and depression by two-sample Mendelian randomization analysis. Single nucleotide polymorphisms (SNPs) associated with SLE were selected as instrumental variables (IVs) from a genome-wide association study (GWAS) of 14,267 European-ancestry participants. A large GWAS of depression (180,866 European-ancestry participants) and another GWAS of major depressive disorder (MDD) (173,005 European-ancestry participants) were selected as outcomes. Then we estimated the effects of IVs on the odds of depression or MDD by using the inverse-variance weighted (IVW) meta-analysis method (random-effects), which had a power of 90% to detect 4% increase of depression in SLE. Interestingly, genetically predicted SLE decreased the odds of depression [odds ratio (OR): 0.995; 95% CI: 0.990–0.999; p = 0.025] and MDD [odds ratio (OR): 0.985; 95% CI: 0.975–0.996; p = 0.009], indicating increased depression in SLE was not due to inheritable risk factors.

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“…The prevalence of mental disorder Psychosis 1.18% [12] -2.54% [13] Mood disorders 2%-60% [14] Anxiety disorders 2.9%-84.9% [15] Cognitive dysfunction 3% [16] -79% [17] Disorder of consciousness 0.9% [11] -7% [18] Sleep disorders 55%-85% [19] Table 2. Neuropsychiatric systemic lupus erythematosus manifestations recognized by the American College of Rheumatology [9] Central nervous system manifestations [30].…”

Section: Mental Disordermentioning

confidence: 99%

“…It co-occurs with many somatic disorders, such as diabetes [32], chronic pain [33], cardiovascular diseases [34] and SLE [35]. According to various studies, the percentage of people with SLE who suffer from depressive disorders is 24%-35% [14,15,35,36]. This percentage is several times higher than in the general population.…”

Section: Mood Disordersmentioning

confidence: 99%

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Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

Szarpak,

Tomasik,

Stanicki

et al. 2024

Curr Probl Psychiatry

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Introduction: Systemic lupus erythematosus is an autoimmune disease affecting up to 210 per 100,000 people in Europe, more often among women. The inflammatory process in lupus causes changes in various organs. However, somatic changes are not the only effects of lupus. The neuropsychiatric manifestations of this disease have been given a separate name – neuropsychiatric lupus. Material and methods: A review of the literature available on the PubMed platform in the period of 1987-2023 was performed using the key words: neuropsychiatric systemic lupus erythematosus, mental disorders, mood disorders, sleep disorders, systemic lupus erythematosus. Original studies, review works, meta-analyses and Internet sources were analyzed. Results: Psychotic disorders in lupus occur with a frequency of up to 3%. Risk factors include young age, male gender and glucocorticoids treatment. Mood disorders occur in several to several dozen percent of lupus patients, including depression affecting up to ⅓ of patients. Belimumab, psychotherapy and improving the quality of sleep, the disturbance of which is observed in most patients with lupus, have potential in treatment. Anxiety disorders are seen primarily in the teenage age group, where social phobia predominates – the fear of rejection due to the disease – and they worsen and are exacerbated by rheumatic disease. Cognitive dysfunctions occur in up to 80% of lupus patients. They are probably related to enzymes of metabolic pathways, dyslipidemia and thyroid dysfunction. Conclusions: Mental disorders develop more often in patients with lupus than in the general population and they predispose to autoimmune diseases. Comprehensive diagnosis and psychiatric care of patients with lupus are necessary. Keywords: systemic lupus erythematosus, sleep disorders, mood disorders, neuropsychiatric systemic lupus erythematosus, mental disorders

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Self-Reported Anxiety and Depression in a Monocentric Cohort of Patients With Systemic Lupus Erythematosus: Analysis of Prevalence, Main Determinants, and Impact on Quality of Life

Cited by 12 publications

References 29 publications

One-Year Outcomes for Depression and Anxiety in SLE Patients

One-Year Outcomes for Depression and Anxiety in SLE Patients

Depression in systemic lupus erythematosus: Modifiable or inheritable? a two-sample mendelian randomization study

Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

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