Background Systemic lupus erythematosus (SLE) is a chronic inflammatory disease in which almost every organ may be affected. Various psychological problems are associated with systemic conditions, but the influence of SLE is still a matter of discussion.
Objectives We evaluated depression, anxiety, anger, fatigue and quality of life in patients with SLE, compared to healthy controls. We also investigated the relationship between these psychological problems, disease activity and damage in patients with SLE.
Methods 108 patients with SLE and 52 healthy controls completed a psychological questionnaire. Psychological parameters were assessed as follows: depression, Center for Epidemiologic Studies Depression Scale (CES-D); anxiety, Hospital Anxiety and Depression Scale (HADS); anger, State Trait Anger Expression Inventory (STAXI); fatigue, the Profile of Mood States fatigue-inertia scale (POM); quality of life (QOL), Functional Assessment Chronic Illness Therapy (FACIT). Disease activity and damage indices were measured by the SLE Disease Activity Index (SLEDAI) and the SLE Collaborating Clinics/American College of Rheumatology (SLICC/ACR), respectively.
Results Patients with SLE showed higher symptoms of depression, anxiety, anger and fatigue (p=0.005; p=0.057; p=0.044; p=0.020, respectively), and lower level of QOL (p=0.003) than healthy controls. In the patients with SLE, mood symptoms such as depression, anxiety, and anger were correlated with each other (depression and anxiety: r=0.710, p<0.001; depression and anger: r=0.602, p<0.001; anxiety and anger: r=0.546, p<0.001). Fatigue and QOL were closely correlated with mood symptoms, respectively. The patients with higher prednisolone use (>7.5 mg/day) showed higher levels of depression, anxiety, anger and fatigue (p=0.002; p=0.022; p=0.027; p=0.010, respectively), and lower level of QOL (p=0.001) than the patients with lower prednisolone use (≤7.5mg/day). However, there were no significant differences in evaluating these parameters according to disease activity or damage indices.
Conclusions The patients with SLE had higher levels of depression, anger and fatigue and lower level of QOL compared to healthy controls. Psychological parameters were affected by daily glucocorticoid dose rather than disease activity or damage indices. These findings suggested that the comprehensive evaluation of the various psychological problems could be helpful to SLE patients, especially those with higher doses of glucocorticoid, even if disease activity and damage are not severe.
Disclosure of Interest None declared