Health-related quality of life in Italian patients with systemic lupus erythematosus. II. Role of clinical, immunological and psychological determinants

Rheumatology (Oxford). 2004 Dec;43(12):1580-6. doi: 10.1093/rheumatology/keh392. Epub 2004 Sep 14.


Objective: To investigate the role of clinical, immunological and psychological variables in influencing the health-related quality of life (HRQOL) of Italian patients with systemic lupus erythematosus (SLE).

Methods: The Medical Outcomes Study Short Form-36 was applied in a cohort of 126 SLE patients. At the time of HRQOL testing all patients underwent a clinical and laboratory evaluation, together with the measure of disease activity, severity and damage. In addition, a battery of psychological tests including the Hamilton Anxiety Scale (HAS) and the Hamilton Depression Rating scale (HAM-D) was applied.

Results: The parameters which seemed to greatly influence the impairment of HRQOL were older age, arthralgia-arthritis and higher HAS scores as well as HAM-D. In multivariate analysis (adjusted for age), arthralgia-arthritis and a higher HAM-D score were associated with HRQOL impairment. No relationship between HRQOL and SLE activity, severity or damage were found. However, a relationship between HAS or HAM-D scores and damage or arthralgia-arthritis was noted.

Conclusion: Anxiety, depression and joint pain seem to be the major determinants of HRQOL impairment in SLE patients. Damage seems to influence HRQOL mostly through depression.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Anxiety / etiology
  • Autoantibodies / blood
  • Biomarkers / blood
  • Depression / etiology
  • Female
  • Health Status Indicators
  • Humans
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / psychology*
  • Lupus Erythematosus, Systemic / rehabilitation*
  • Male
  • Mental Disorders / etiology*
  • Middle Aged
  • Pain Measurement
  • Psychiatric Status Rating Scales
  • Quality of Life*
  • Risk Factors


  • Autoantibodies
  • Biomarkers