Depressive Symptoms and Associated Factors in Systemic Lupus Erythematosus
Depressive Symptoms and Associated Factors in Systemic Lupus Erythematosus
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DOI：
10.1016/j.psym.2012.09.004
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发表时间：
2013-09-01
期刊：
影响因子：
3.4
通讯作者：
Clowse, Megan E. B.
中科院分区：
文献类型：
--
作者：
Karol, David E.;Criscione-Schreiber, Lisa G.;Clowse, Megan E. B.
背景：抑郁症状影响 11% 至 71% 的系统性红斑狼疮 (SLE) 患者，这可能与 SLE 疾病活动性、其他临床变量或社会人口因素有关。目的：我们的目的是测量 SLE 患者队列中抑郁症状的发生率，并确定与抑郁症状相关的可改变因素。方法：我们大学 SLE 登记处的患者完成了贝克抑郁量表 II (BDI-II)、疼痛评分和人口统计信息。使用医师总体评估（PGA）和Selena-SLE疾病活动指数（Selena-系统性红斑狼疮疾病活动指数（SLEDAI））来测量疾病活动性。患者被确定为有中度或重度抑郁症状（BDI-II >= 18）或没有（BDI-II < 18）。适当使用非参数检验和 chi(2) 检验来比较组间变量。结果：127 人中有 53 人 (41.7%) 被确定患有中度或重度抑郁症状，这些症状与较高的疼痛水平和较低的自我报告的当前健康状况有关。有中度或重度抑郁症状的患者（49%）比没有或轻度抑郁症状的患者（18%）更有可能患有狼疮关节炎（P < 0.01）。在53名患有中度或重度抑郁症状的患者中，只有26名患者（49.0%）服用了抗抑郁药物，并且只有8/53名患者（15.0%）服用了最大剂量的抗抑郁药物。结论：本研究发现我们的 SLE 患者队列中有 41.7% 存在中度或重度抑郁症状。与这些症状相关的最重要的变量是疼痛。改善疼痛（尤其是狼疮关节炎疼痛）的治疗可能会减轻系统性红斑狼疮患者的抑郁症状。
Background: Depressive symptoms affect anywhere from 11% to 71% of patients with systemic lupus erythematosus (SLE), which may be related to SLE disease activity, other clinical variables, or sociodemographic factors. Objective: We aimed to measure the rate of depressive symptoms in our cohort of patients with SLE and to identify) modifiable factors associated with depressive symptoms. Methods: Patients in our university-based SLE registry completed the Beck Depression Inventory-II (BDI-II), pain scores, and demographic information. Disease activity was measured using the physician's global assessment (PGA) and Selena-SLE disease activity index (Selena-systemic lupus erythematosus disease activity index (SLEDAI)). Patients were identified as having moderate or severe depressive symptoms (BDI-II >= 18) or not (BDI-II < 18). Nonparametric tests and chi(2) tests were used as appropriate to compare variables between groups. Results: Fifty-three of 127 people (41.7%) were identified as having moderate or severe depressive symptoms, which were associated with higher pain levels and lower self-reported of current health status. Patients with moderate or severe depressive symptoms were more likely (49%) than those with no or mild depressive symptoms (18%) to have lupus arthritis (P < 0.01). Of the 53 patients with moderate or severe depressive symptoms, only 26 (49.0%) were prescribed antidepressants, and only 8/53 patients (15.0%) were prescribed the maximum dose of antidepressant. Conclusions: This study identified moderate or severe depressive symptoms in 41.7% of our cohort of patients with SLE. The most significant variable associated with these symptoms was pain; improved treatment of pain, and in particular from lupus arthritis, may result in alleviation of depressive symptoms in patients with SLE.