在系统性红斑狼疮患者中，活动性疾病与更严重的焦虑症状独立相关，而非抑郁症状。

Active disease is independently associated with more severe anxiety rather than depressive symptoms in patients with systemic lupus erythematosus.

作者信息

Tay S H, Cheung P P M, Mak A

机构信息

Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

Lupus. 2015 Nov;24(13):1392-9. doi: 10.1177/0961203315591026. Epub 2015 Jun 17.

DOI:10.1177/0961203315591026

PMID:26085594

Abstract

OBJECTIVE

The inter-correlation between and co-existence of depression and anxiety may engender inconsistency in addressing the relationship between the severity of depression and disease activity of systemic lupus erythematosus (SLE). We aimed at identifying whether lupus disease activity is independently associated with depression and anxiety in lupus patients.

METHODS

Adult lupus patients were assessed for the severity of depressive and anxiety symptoms and lupus disease activity by using the Hospital Anxiety and Depression Scale (HADS) and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), respectively. Age- and gender-matched healthy controls (HCs) were recruited for comparison. Prevalence and severity of depressive and anxiety symptoms were compared between lupus patients and HCs. Independent relationships between the severity of anxiety (HADS-Anxiety) and depressive (HADS-Depression) symptoms, and SLEDAI were studied with regression models.

RESULTS

In total, 110 lupus patients and 110 HCs were studied. Lupus patients had significantly higher HADS scores than HCs (10.82 ± 6.5 vs. 7.34 ± 4.9, p < 0.001). Significantly more lupus patients had anxiety (40.9 vs. 21.8%, p = 0.002) and depressive symptoms (15.5 vs. 6.4%, p = 0.025) than HCs. Multiple linear regression analyses revealed that SLEDAI (β = 0.160, p = 0.016), calcineurin inhibitor non-use (β = -1.929, p = 0.041) and past cyclophosphamide non-use (β = -1.603, p = 0.039) independently predicted HADS-Anxiety amongst lupus patients even after adjusting for HADS-Depression. Conversely, SLEDAI (β = 0.014, p = 0.834) lost its significant univariate correlation with HADS-Depression after controlling for HADS-Anxiety and other covariates.

CONCLUSION

Anxiety is more common in lupus patients than in HCs, and its severity is independently associated with more active SLE regardless of the presence or absence of concomitant depression.

摘要

目的

抑郁与焦虑之间的相互关联及共存可能导致在阐述抑郁症严重程度与系统性红斑狼疮（SLE）疾病活动度之间的关系时出现不一致。我们旨在确定狼疮疾病活动度是否与狼疮患者的抑郁和焦虑独立相关。

方法

分别使用医院焦虑抑郁量表（HADS）和系统性红斑狼疮疾病活动指数（SLEDAI）对成年狼疮患者的抑郁和焦虑症状严重程度以及狼疮疾病活动度进行评估。招募年龄和性别匹配的健康对照（HCs）进行比较。比较狼疮患者和HCs之间抑郁和焦虑症状的患病率及严重程度。使用回归模型研究焦虑（HADS-焦虑）和抑郁（HADS-抑郁）症状严重程度与SLEDAI之间的独立关系。

结果

共研究了110例狼疮患者和110例HCs。狼疮患者的HADS评分显著高于HCs（10.82±6.5对7.34±4.9，p<0.001）。狼疮患者出现焦虑（40.9%对21.8%，p=0.002）和抑郁症状（15.5%对6.4%，p=0.025）的比例显著高于HCs。多元线性回归分析显示，即使在调整了HADS-抑郁后，SLEDAI（β=0.160，p=0.016）、未使用钙调神经磷酸酶抑制剂（β=-1.929，p=0.041）和既往未使用环磷酰胺（β=-1.603，p=0.039）仍可独立预测狼疮患者的HADS-焦虑。相反，在控制了HADS-焦虑和其他协变量后，SLEDAI（β=0.014，p=0.834）与HADS-抑郁失去了显著的单变量相关性。