Abstract

BackgroundDepression is common in systemic lupus erythematosus (SLE) and is an unmeasured risk factor, yet its symptoms can be neglected in standard disease evaluations. The purpose of this study was to assess the frequency and the impact of depression on quality of life in SLE patients. We recruited 32 patients with SLE and 15 healthy control volunteers in the study. The following investigations were undertaken in each patient: clinical and rheumatologic assessment, SLE Disease Activity Index-2k (SLEDAI-2k), Beck Depression Inventory (BDI), Short-Form Health Survey (SF-36) questionnaire, and routine laboratory tests.ResultsThere was a high percentage of depression (46.9%) in the SLE patients. Regarding quality of life (SF-36), there were significant affection of the physical and mental composite summary domains (PCS and MCS) scores in lupus patients compared with controls (P < 0.000 for both) with the same significant in depressed compared with non-depressed patients. SF-36 subscales (physical function, limit emotional, emotional wellbeing, and social function) were significantly affected in depressed lupus patients compared with non-depressed patients. There was a significant negative correlation between the score of MCS domain of SF-36 with BDI (P < 0.000) while positive correlation between SLEDAI score with depression score. In contrast, there were no significant correlations between MCS or PCS with age, duration of illness, or SLEDAI-2K.ConclusionsDepression is common in SLE patients and had a negative impact on quality of life particularly on MCS domain and positive correlation with disease severity score.Trial registrationThis study was registered on clinical trial with registration number: NCT03165682 https://clinicaltrials.gov/ct2/show/NCT03165682 on 24 May 2017.

Highlights

  • Depression is common in systemic lupus erythematosus (SLE) and is an unmeasured risk factor, yet its symptoms can be neglected in standard disease evaluations

  • Regarding health-related quality of life (HRQoL) (SF-36), there were significant affection of the Physical composite scale (PCS) and Mental composite scale (MCS) scores in lupus patients compared with controls (P = 0.000 for both) with the same significant in depressed patients compared with non-depressed patients

  • Concerning the subscales of Short-Form Health Survey (SF-36), all were significantly affected in depressed lupus patients compared with non-depressed patients

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Summary

Introduction

Depression is common in systemic lupus erythematosus (SLE) and is an unmeasured risk factor, yet its symptoms can be neglected in standard disease evaluations. The following investigations were undertaken in each patient: clinical and rheumatologic assessment, SLE Disease Activity Index-2k (SLEDAI-2k), Beck Depression Inventory (BDI), Short-Form Health Survey (SF-36) questionnaire, and routine laboratory tests. Systemic lupus erythematosus (SLE) is a progressive autoimmune disease characterized by a wide range of clinical manifestations and an erratic disease path that includes remissions and exacerbations [1]. Neuropsychiatric systemic lupus erythematosus (NPSLE) is one of the most severe forms of SLE, characterized by psychiatric, central, and peripheral neurological signs and symptoms [2]. Metabolic neuroimaging (positron emission tomography/PET, MR spectroscopy) and perfusion imaging (single photon emission computer tomography/SPECT) can detect abnormalities in patients who present exclusively with psychiatric manifestations. The functional near infrared spectroscopy (fNIRS) neuroimaging could be used to elucidate the pathophysiology of psychiatric disorders and identify neurophysiological differences between co-occurring psychiatric disorders [11, 12]

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