Stressful Life Events and Skin Diseases: An Additional Perspective from Research on Psychosomatic Dynamics in Systemic Lupus erythematosus

Schubert, Christian; Geser, Willi; Noisternig, Bianca; König, Paul; Rumpold, Gerhard; Lampe, Astrid

doi:10.1159/000049356

Cited by 18 publications

(20 citation statements)

References 3 publications

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“…Therefore, one could suggest that SLE patients with enhanced psychosocial stress may be more susceptible to get a cold, and thus to also more readily develop a flare compared to SLE patients who have only low levels of psychosocial stress. Additionally, other research has shown that minor stressors such as daily psychosocial incidents were followed by an increase in urine cortisol and neopterin in a single case study of an SLE patient [20, 21], pointing at the importance of more studies to analyze the effects of daily stressors on disease activity and altered neuroendocrine and immune functions in SLE [22, 23]. …”

Section: Discussionmentioning

confidence: 99%

Flares in Patients with Systemic Lupus erythematosus Are Associated with Daily Psychological Stress

Pawlak

Witte²,

Heiken³

et al. 2003

Psychother Psychosom

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Background: The aetiology of systemic lupus erythematosus (SLE) remains unclear. Clinical observations and a small number of studies performed so far suggest an association between psychological stress and self-reported symptoms of SLE patients. This longitudinal study was designed to investigate whether daily psychological stress is associated with flares in SLE patients, measured by clinical and laboratory parameters. Methods: Female SLE patients (n = 41) were followed over a period of six months. Daily stress was monitored by a hand-held PC diary programmed with 44 items based on standardized measures and clinical experience. Once every four weeks patients visited the outpatient clinic for medical evaluation. Disease activity was evaluated using the European Consensus Lupus Activity Measurement (ECLAM), laboratory parameters, and intake of steroids. Results: Classification and regression tree (CART) patient-wise analyses revealed that SLE patients with vs. without flares using complement and ECLAM as activity measures show greater negative self-ratings in mood, and social duties (p < 0.01). In addition, mixed model analysis of variance showed that daily hassles with social relationships were significantly associated with flares in SLE measured by an increase in steroid medication >5mg/d (p < 0.01). Conclusions: These results suggest that psychological stress is associated with flares in SLE. Particularly daily stress with social relationships and social duties may be factors to be related to the course of disease activity in SLE.

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Section: Discussionmentioning

confidence: 99%

Flares in Patients with Systemic Lupus erythematosus Are Associated with Daily Psychological Stress

Pawlak

Witte²,

Heiken³

et al. 2003

Psychother Psychosom

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“…In addition, stress has been described as a trigger and may worsen the patient’s condition in cases of SLE [1,2,3,4,5,6,7,8,9,10] and other autoimmune diseases [11,12]. Some studies [3,4,5,6,7,8,9,10] have shown that chronic stress (low-intensity events repeated over time) is most strongly linked to deterioration in patients with the disease. Peralta-Ramírez et al [8] evaluated 58 patients with lupus (46 with SLE and 12 with CCL) for 6 months and found that chronic stress worsened the symptoms of the disease to the greatest degree, and this was observed in up to 74% of patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Navarrete‐Navarrete

Peralta-Ramírez

Sabio-Sánchez

et al. 2010

Psychother Psychosom

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Background: Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. Methods: Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. Results: We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. Conclusions: CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients’ QOL, despite there being no significant reduction in the disease activity index.

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“…Rather, the finding that decreases in the patient's mood preceded neopterin increases with a long temporal delay of 96 h suggests that mood decreases may have been parallelized by psychosocial stressors. This suggestion is backed up by results from our recent studies on 3 patients with systemic lupus erythematosus, in which the occurrence of emotionally meaningful stressors preceded increases in urinary neopterin levels by 48-60 h [11] . This study's findings are only preliminary results, particularly as they are based on only a single case.…”

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confidence: 89%

Mood and Fatigue in Everyday Life Are Temporally Related to Cellular Immune Activity

Schubert¹,

Neises

Fritzsche

et al. 2009

Psychopathology

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Stressful Life Events and Skin Diseases: An Additional Perspective from Research on Psychosomatic Dynamics in Systemic Lupus erythematosus

Cited by 18 publications

References 3 publications

Flares in Patients with Systemic Lupus erythematosus Are Associated with Daily Psychological Stress

Flares in Patients with Systemic Lupus erythematosus Are Associated with Daily Psychological Stress

Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Mood and Fatigue in Everyday Life Are Temporally Related to Cellular Immune Activity

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