Nishimura K, Omori M, Katsumata Y, Sato E, Kawaguchi Y, Harigai M, Yamanaka H, Ishigooka J
Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
Kanagawa Psychiatric Center, Yokohama, Japan.
Lupus. 2016 Apr;25(5):463-71. doi: 10.1177/0961203315615223. Epub 2015 Nov 1.
Psychological distress, such as depression and anxiety, has been intensively studied in patients with systemic lupus erythematosus (SLE). However, those studies have mostly included patients who were treated with corticosteroids, which might themselves induce mood disturbances. We investigated psychological distress in corticosteroid-naive patients with SLE who did not exhibit any overt neuropsychiatric manifestations.
Forty-three SLE in-patients with no current or past abnormal neuropsychiatric history participated in the study. Patients and 30 healthy control subjects with similar demographic and personality characteristics were administered a comprehensive battery of psychological/neuropsychological tests. The Profile of Mood States (POMS) was used to assess depression and anxiety. Results of clinical, laboratory, and neurological tests were compared with regard to their presence.
Prevalence of depression was higher in patients (n = 11, 25.6%) than in controls (n = 2, 6.7%; p = 0.035), although prevalence of anxiety did not differ across groups (patients: 34.9%, n = 15; controls: 16.7%, n = 5; p = 0.147). Using multiple logistic regression analysis, we identified avoidance coping methods (OR, 1.3; 95% CI 1.030-1.644; p = 0.027) as an independent risk factor for depression.
Our results indicate that depression presents more frequently in corticosteroid-naive patients with early-stage, active SLE than in the normal population, but anxiety does not. Depression may be related to psychological reactions to suffering from the disease.
心理困扰，如抑郁和焦虑，已在系统性红斑狼疮（SLE）患者中得到深入研究。然而，这些研究大多纳入了接受皮质类固醇治疗的患者，而皮质类固醇本身可能会诱发情绪障碍。我们调查了未出现任何明显神经精神表现且未使用过皮质类固醇的SLE患者的心理困扰情况。
43例目前或既往无神经精神异常病史的SLE住院患者参与了本研究。对患者和30名具有相似人口统计学和性格特征的健康对照者进行了一系列全面的心理/神经心理测试。使用情绪状态剖面图（POMS）评估抑郁和焦虑。比较临床、实验室和神经学检查结果的出现情况。
患者中抑郁的患病率（n = 11，25.6%）高于对照组（n = 2，6.7%；p = 0.035），尽管焦虑的患病率在两组间无差异（患者：34.9%，n = 15；对照组：16.7%，n = 5；p = 0.147）。通过多元逻辑回归分析，我们确定回避应对方式（比值比，1.3；95%置信区间1.030 - 1.644；p = 0.027）是抑郁的一个独立危险因素。
我们的结果表明，未使用过皮质类固醇的早期活动性SLE患者中抑郁的出现频率高于正常人群，但焦虑并非如此。抑郁可能与对疾病痛苦的心理反应有关。
