Zhang Xuan, Wang Zhe, Lin Gui-Ling, Wei Fang-Zhi, Zhuang Yan-Ping, Xu Wen-Lu, Zhang Qi, Wu Hui-Tao, He Zi-Man, Yin Xi-Yu, Liu Ying, Mi Long, Gong Ai-Min
School of Traditional Chinese Medicine, Hainan Medical University, Haikou 571101, Hainan Province, China.
Department of Rheumatology and Immunology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China.
World J Psychiatry. 2024 Jun 19;14(6):829-837. doi: 10.5498/wjp.v14.i6.829.
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder with varied clinical courses and prognoses, not only did the patients suffer from physical impairment, but also various physical and psychiatric comorbidities. Growing evidence have suggested that mental disorders in SLE patients, can lead to various adverse consequences.
To explored the features and influencing factors of mental health in patients with SLE and clarifying the correlations between mental health and personality characteristics and perceived social support. The results would provide a basis for psychological intervention in patients with SLE.
The clinical data of 168 patients with SLE admitted at the First Affiliated Hospital of Hainan Medical University between June 2020 and June 2022 were collected. Psychological assessment and correlation analysis were conducted using the Symptom Checklist-90 (SCL-90) and Perceived Social Support Scale, and the collected data were compared with the national norms in China. The relevant factors influencing mental health were identified by statistical analysis. A general information questionnaire, the Revised Life Orientation Test, and Short-Form 36-Item Health Survey were employed to assess optimism level and quality of life (QoL), respectively.
Patients with SLE obtained higher scores for the somatization, depression, anxiety, and phobic anxiety subscales than national norms ( < 0.05). A correlation was identified between total social support and total SCL-90 score or each subscale ( < 0.05). The factors significantly affecting patients' mental health were hormone dosage and disease activity index (DAI) ( < 0.05). The average optimism score of patients with SLE was 14.36 ± 4.42, and 30 cases were in the middle and lower levels. A positive correlation was found between optimism level and QoL scores.
Patients with SLE develop psychological disorders at varying degrees, which are significantly influenced by hormone dosage and DAI. Patients' mental health should be closely monitored during clinical diagnosis and treatment and provided adequate support in establishing positive, healthy thinking and behavior patterns and improving their optimism level and QoL.
系统性红斑狼疮（SLE）是一种异质性自身免疫性疾病，临床病程和预后各异，患者不仅遭受身体损害，还伴有各种躯体和精神合并症。越来越多的证据表明，SLE患者的精神障碍会导致各种不良后果。
探讨SLE患者心理健康的特征及影响因素，阐明心理健康与人格特征及感知社会支持之间的相关性。研究结果将为SLE患者的心理干预提供依据。
收集2020年6月至2022年6月在海南医学院第一附属医院住院的168例SLE患者的临床资料。采用症状自评量表（SCL - 90）和感知社会支持量表进行心理评估和相关性分析，并将收集的数据与中国国内常模进行比较。通过统计分析确定影响心理健康的相关因素。分别采用一般信息问卷、修订的生活取向测验和简明健康调查36项量表评估乐观水平和生活质量（QoL）。
SLE患者在躯体化、抑郁、焦虑和恐惧焦虑分量表上的得分高于国内常模（<0.05）。社会支持总分与SCL - 90总分或各分量表之间存在相关性（<0.05）。显著影响患者心理健康的因素是激素剂量和疾病活动指数（DAI）（<0.05）。SLE患者的平均乐观得分为14.36±4.42，30例处于中下水平。乐观水平与QoL得分呈正相关。
SLE患者存在不同程度的心理障碍，受激素剂量和DAI影响显著。临床诊疗过程中应密切监测患者心理健康，在帮助患者建立积极、健康的思维和行为模式、提高乐观水平和QoL方面给予充分支持。
