Depressive and Anxiety Disorders in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations.

Ru Bai,Shuang Liu,Aiyun Lai,Zhaoping Lu,Yuqi Cheng,Xinyu Xu,Zhongqi Xie,Jian Xu,Yueyin Zhao,Shu Li

doi:10.1155/2016/2829018

Abstract

Depressive and anxiety disorders are frequently observed in patients with Systemic Lupus Erythematosus (SLE). However, the underlying mechanisms are still unknown. We conducted this survey to understand the prevalence of depression and anxiety in SLE patients without major neuropsychiatric manifestations (non-NPSLE) and to explore the relationship between emotional disorders, symptoms, autoantibodies, disease activity, and treatments in SLE. 176 SLE patients were included, and SLE disease activity index (SLEDAI), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) were recorded to evaluate their disease activity and emotional status. We found that depressive and anxiety disorders were common among SLE patients: 121 (68.8%) patients were in depression status while 14 (8.0%) patients could be diagnosed with depression. Accordingly, 101 (57.4%) were in anxiety status and 21 (11.9%) could be diagnosed with anxiety. Depression was associated with disease activity, and anxiety was associated with anti-P0 antibody, while both of them were associated with proteinuria. HAMA and HAMD scores were in strong positive correlation and they were independent risk factors of each other. We concluded that the high prevalence of depression and anxiety and the association between depression and SLE disease activity might reveal the covert damage of central nervous system in SLE. The role of anti-P0 antibody in SLE patients with emotional disorders warrants more researches.

Highlights

Systemic Lupus Erythematosus (SLE) is a typical connective tissue disease with multiple organs involved, including central nervous system (CNS), peripheral nervous system (PNS), and autonomic nervous system
When we analyzed the possible risk factors we got from the analysis above in binary logistic regression, we found that only pyuria, hematuria, and Hamilton Anxiety Rating Scale (HAMA) score were the risk factors of depression, and proteinuria, SLE disease activity index (SLEDAI), and cumulative dosage of HCQ were not significantly relevant
Neuropsychiatric symptoms are major symptoms in SLE patients, and 19 of them are considered as neuropsychiatric Systemic Lupus Erythematosus (NPSLE)

Summary

Introduction

Systemic Lupus Erythematosus (SLE) is a typical connective tissue disease with multiple organs involved, including central nervous system (CNS), peripheral nervous system (PNS), and autonomic nervous system. SLE is characterized by repeated flares and remissions of variable symptoms and signs, of which proteinuria, rashes, and arthritis are the most common ones Besides those frustrating symptoms, social stress such as loss of working abilities, decreased incomings, and limitations in social activities are a major problem. Social stress such as loss of working abilities, decreased incomings, and limitations in social activities are a major problem They may cause emotional disorders like depression and anxiety in SLE patients [5]. Our study included 176 nonNPSLE patients with normal conventional brain imaging and no history of neuropsychiatric disease and intended to explore the prevalence of depression and anxiety in these patients and understand the relationship between emotional disorders, symptoms, autoantibodies, disease activity, and treatments in SLE

Materials and Methods

Results

Discussion