Stress as a trigger of disease flares in SLE

Abstract

Patients with systemic lupus erythematosus were asked to report their perceptions as to whether stress can trigger disease flares. A total of 54 patients treated at two District General Hospitals in Essex were included in the analysis. They were 4 males and 50 females and were 20 Caucasians, 22 Asians, and 12 Africans/Afro-Caribbean. Thirty-three of 54 patients (61.1%) reported stress to be a trigger for disease flares. Although most (85%) of the Caucasian patients reported that stress triggered their disease flares, only 50% of the African/Afro-Caribbean patients and 45.4% of the Asian patients reported stress as a trigger for disease flares. No correlation was found between reported number of flares per year and characteristics such as age (P = 0.4), age at diagnosis (P = 0.8), age at disease onset (P = 0.6), or disease duration (P = 0.2). A trend towards a significant correlation was observed between the number of reported flares per year and the number of children a patient has (P = 0.07).

Relationships Between Adverse Childhood Experiences and Health Status in Systemic Lupus Erythematosus

“…Development of SLE is influenced by genetic susceptibility as well as environmental interactions (1)(2)(3). Stress has been implicated as a potential trigger of disease onset and flares as well as chronic disability (4)(5)(6)(7)(8). Exploring how a history of major stress, such as childhood abuse and neglect, impacts outcomes may inform the association between stress and SLE.…”

Elevated Salivary Alpha-Amylase Level, Association Between Depression and Disease Activity, and Stress as a Predictor of Disease Flare in Systemic Lupus Erythematosus

“… 1 Mental distress also has been known to provoke deterioration of disease course; this is a common thought among clinicians and patients suffering for a prolonged period. 2 The theoretical background that supports such association is psychoneuroimmunology, which covers the key mechanistic evidence of the communications that connect immune, central nervous (CNS), and endocrine systems. The CNS, which is affected by mental distress, signals the immune system via hormonal and neuronal pathways, and the immune system affects the CNS through diverse cytokines.…”

Psychoanalytic psychotherapy improves quality of life, depression, anxiety and coping in patients with systemic lupus erythematosus: a controlled randomized clinical trial

“…More psychoanalytic research is needed to clarify the relationship of the immune system and patient's psychological function. Believing that psychological function can be one of the factors that participate as cause and trigger of SLE flares [3,4], psychotherapeutic support may be useful to supplement clinical and pharmacological treatments in these patients. Psychotherapy group treatment should be offered at specialized centers to treat SLE patients because it can allow cost reduction and emotional benefits for coexistence and exchange of experiences among patients, besides higher effectiveness than individual treatment, according to a systematic review [47].…”

“…The connection between the limbic system, hypothalamicpituitary-adrenal (HPA) axis and autonomous nervous system has the function to restore body baseline status after exposition to physical or psychological stress [2]. Some authors evaluated the influence of stress as one of the causal factors of SLE and also as a trigger of disease flares [3,4].…”