Department of Medicine, Division of Rheumatology, University of Cyprus Medical School, Nicosia, Cyprus and University of Arizona College of Medicine, Phoenix, AZ, USA.
Nicosia General Hospital.
Rheumatology (Oxford). 2021 Nov 3;60(11):5369-5378. doi: 10.1093/rheumatology/keab123.
To determine the contributing factors associated with major depressive disorder (MDD) in SLE patients and examine the association between disease-specific health-related quality of life [lupus quality of life (LupusQoL)] domains and MDD.
Depression was assessed by the patient health questionnaire (PHQ)-9, and scores ≥10 indicate MDD. Demographic data, LupusQoL domains, clinical and other features of the SLE patients were described and compared between MDD (PHQ-9 ≥10) and non-MDD (PHQ-9 <10) groups using χ2 tests for categorical variables and Wilcoxon rank sum tests for non-normal continuous variables. The risk of MDD was evaluated for the patient and physician-reported features individually using log-binomial models to estimate relative risks and 95% confidence limits.
Eighty-eight patients with SLE met eligibility criteria, with a mean (range) age of 48.6 (19-80), mostly female (80%) and with a mean disease duration of 13.2 years. Compared with the non-MDD group, patients with MDD (n = 32, 36%) were more likely to have the following SLE manifestations: mucocutaneous, vascular, ocular, pulmonary and musculoskeletal involvement. Self-rated health described as poor/fair was markedly associated with MDD (P < 0.001, relative risk = 0.48). Based on relative risks, higher pain visual analogue score, and patient and physician global assessment scores were also linked to MDD. The LupusQoL domain scores were notably lower in the MDD patients, with a statistically significant reduction in all LupusQoL domains.
Predictors of MDD in SLE patients include higher scores in pain and global assessment, poor or fair self-reported health, and specific organ involvement. These findings may help clinicians to recognize and manage MDD promptly.
确定与系统性红斑狼疮（SLE）患者重度抑郁症（MDD）相关的影响因素，并探讨疾病特异性健康相关生活质量[狼疮生活质量（LupusQoL）]领域与 MDD 之间的关联。
采用患者健康问卷（PHQ-9）评估抑郁情况，得分≥10 分表示存在 MDD。描述并比较 MDD（PHQ-9≥10）和非 MDD（PHQ-9<10）组患者的人口统计学数据、LupusQoL 领域、临床和其他 SLE 特征，分类变量采用卡方检验，非正态连续变量采用 Wilcoxon 秩和检验。分别使用对数二项式模型评估患者和医生报告的特征发生 MDD 的风险，以估计相对风险和 95%置信区间。
88 例符合条件的 SLE 患者，平均（范围）年龄为 48.6（19-80）岁，大多数为女性（80%），平均病程为 13.2 年。与非 MDD 组相比，MDD 患者（n=32，36%）更有可能出现以下 SLE 表现：黏膜皮肤、血管、眼部、肺部和肌肉骨骼受累。自我报告的健康状况差/差与 MDD 明显相关（P<0.001，相对风险=0.48）。基于相对风险，更高的疼痛视觉模拟评分以及患者和医生的总体评估评分也与 MDD 相关。MDD 患者的 LupusQoL 领域评分明显较低，所有 LupusQoL 领域的评分均有统计学意义的降低。
SLE 患者 MDD 的预测因素包括疼痛和总体评估评分较高、自我报告的健康状况较差/差，以及特定器官受累。这些发现可能有助于临床医生及时识别和治疗 MDD。
