Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea.
Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Clin Exp Rheumatol. 2018 Jul-Aug;36(4):627-635. Epub 2018 Feb 14.
Depression is more common in patients with systemic lupus erythematosus (SLE) compared to the general population. However, few studies have investigated risk factors of depression in SLE patients, and the results are inconsistent. This study evaluated the prevalence of, and risk factors for, depression in ethnically homogeneous Korean SLE patients.
In this study, 505 consecutive SLE patients were enrolled from the Korean Lupus Network registry. Demographic variables, clinical manifestations, laboratory findings, physician global assessment, and SLEDAI-2000 and SLICC damage index were recorded at enrolment. Patients were identified as having depressive symptoms using the Korean version of the Beck Depression Inventory (BDI) with a cut-off ≥16, and categorised into four groups. Multivariable logistic regression analyses were performed to identify independent risk factors for depression defined as a BDI score ≥16.
Of the 505 patients, 97 (19.2%) were diagnosed with depression. Patients with a higher BDI score were older, more likely to be a current smoker, and had a SLICC score >1. Conversely, they had lower income and educational levels. Regarding the serologic findings, patients with a higher BDI score had lower anti-double-stranded DNA positivity and higher anticardiolipin (aCL) positivity. On multivariate analysis, the following factors were associated with depression: current smoking status (OR 2.533, p=0.049), aCL-positivity (OR 2.009, p=0.035), and a SLICC damage index score >1 (OR 2.781, p=0.039). On the other hand, high-level education (OR 0.253, p=0.024) and a high income (OR 0.228, p=0.008) were negatively associated with depression.
Our results show that depression is prevalent in patients with SLE and multiple factors are associated with depression in SLE. These data could help guide target programmes for those at high risk of depression in SLE.
与普通人群相比，系统性红斑狼疮（SLE）患者更易出现抑郁。然而，很少有研究调查 SLE 患者抑郁的危险因素，且结果不一致。本研究评估了韩国同种族 SLE 患者中抑郁的患病率和危险因素。
本研究纳入了来自韩国狼疮网络登记处的 505 例连续 SLE 患者。在入组时记录了人口统计学变量、临床表现、实验室检查结果、医生整体评估以及 SLEDAI-2000 和 SLICC 损伤指数。使用贝克抑郁量表（BDI）的韩国版本（临界值≥16）确定有抑郁症状的患者，并将其分为四组。采用多变量逻辑回归分析确定 BDI 评分≥16 定义的抑郁的独立危险因素。
在 505 例患者中，97 例（19.2%）被诊断为抑郁症。BDI 评分较高的患者年龄较大、更可能是当前吸烟者，且 SLICC 评分>1。相反，他们的收入和教育水平较低。在血清学发现方面，BDI 评分较高的患者抗双链 DNA 阳性率较低，抗心磷脂（aCL）阳性率较高。多变量分析显示，以下因素与抑郁相关：当前吸烟状态（OR 2.533，p=0.049）、aCL 阳性（OR 2.009，p=0.035）和 SLICC 损伤指数评分>1（OR 2.781，p=0.039）。另一方面，高教育水平（OR 0.253，p=0.024）和高收入（OR 0.228，p=0.008）与抑郁呈负相关。
我们的研究结果表明，SLE 患者中抑郁较为常见，且多个因素与 SLE 中的抑郁相关。这些数据可以帮助指导 SLE 中那些有较高抑郁风险的患者的目标计划。
