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Patients with SLE more likely to have lower quality of life, mood disorders
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Health-related quality of life was impaired in patients with systemic lupus erythematosus and mood disorders such as anxiety and depression were prevalent, according to researchers in Istanbul, Turkey.
A cohort of 113 patients with systemic lupus erythematosus (SLE) and 123 healthy individuals matched for age and sex were followed through the Marmara University Medical Faculty Rheumatology outpatient clinics. Participants in both groups were required to be older than 18 years of age and were excluded in the presence of psychiatric disorder.
Health-related quality of life (HRQoL) was measured using SF-36, and disease activity was measured using the SLE disease activity index (SLEDAI) and physician’s global assessment (PGA), both scored by the same physician blinded to other survey results.
Mean age was 40.6 years in the patients with SLE and 40.7 in healthy participants, and 108 of the patients with SLE were women. Median disease duration was 6 years. Additionally, 77% of patients with were not employed, compared with 82.9% of healthy participants.
Active disease was seen in 84 patients (69%), 40 of whom were classified as having mild disease, 28 with moderate and eight had severe disease activity. Median erythrocyte sedimentation rate was 22 mm per hour and median C-reactive protein was 2.75 mg/dL.
Low-dose steroids were used by 47% of patients, 19% used high doses of steroids. Hydroxychloroquine was used by 76% of patients and 57% were on immunosuppressants.
The Hospital Anxiety and Depression Scale (HADS) and SF-36 were administered to all participants to evaluate quality of life (QoL).
Mean values of HADS-anxiety (HADS-A) scores in patients with SLE was 7.3 (median 7, range 0 to 20) compared with 5.7 (median 5, range 0 to 17) in healthy participants, according to the researchers. Mean HADS-depression (HADS-D) scores for patients with SLE were 6.1 (median 5, range 0 to 17) and 5.1 (median 6, range 0 to 18) in healthy participants.
In patients with SLE, 16.8% scored as possible, 15.9% scored as probable and 5.3% scored as extreme cases of depression and 18.5% scored as possible, 16.8% scored as probably and 10.6% scored as extreme cases of anxiety.
No correlation was seen between SLEDAI and any of the SF-36 subscales or disease duration. All domains of the SF-36 and physical and mental scores in other surveys were impaired in patients with SLE compared with healthy participants. Age was correlated with lower HRQoL, but the relationship was not seen after multivariate regression analysis, according to the researchers. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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