Depressive symptoms and associated factors in systemic lupus erythematosus

Psychosomatics. 2013 Sep-Oct;54(5):443-50. doi: 10.1016/j.psym.2012.09.004. Epub 2012 Dec 27.


Background: Depressive symptoms affect anywhere from 11% to 71% of patients with systemic lupus erythematosus (SLE), which may be related to SLE disease activity, other clinical variables, or sociodemographic factors.

Objective: We aimed to measure the rate of depressive symptoms in our cohort of patients with SLE and to identify modifiable factors associated with depressive symptoms.

Methods: Patients in our university-based SLE registry completed the Beck Depression Inventory-II (BDI-II), pain scores, and demographic information. Disease activity was measured using the physician's global assessment (PGA) and Selena-SLE disease activity index (Selena-systemic lupus erythematosus disease activity index (SLEDAI)). Patients were identified as having moderate or severe depressive symptoms (BDI-II ≥ 18) or not (BDI-II < 18). Nonparametric tests and χ(2) tests were used as appropriate to compare variables between groups.

Results: Fifty-three of 127 people (41.7%) were identified as having moderate or severe depressive symptoms, which were associated with higher pain levels and lower self-reported of current health status. Patients with moderate or severe depressive symptoms were more likely (49%) than those with no or mild depressive symptoms (18%) to have lupus arthritis (P < 0.01). Of the 53 patients with moderate or severe depressive symptoms, only 26 (49.0%) were prescribed antidepressants, and only 8/53 patients (15.0%) were prescribed the maximum dose of antidepressant.

Conclusions: This study identified moderate or severe depressive symptoms in 41.7% of our cohort of patients with SLE. The most significant variable associated with these symptoms was pain; improved treatment of pain, and in particular from lupus arthritis, may result in alleviation of depressive symptoms in patients with SLE.

MeSH terms

  • Adult
  • Arthritis / etiology
  • Arthritis / psychology
  • Cohort Studies
  • Depression / drug therapy
  • Depression / psychology*
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / psychology*
  • Lupus Erythematosus, Systemic / therapy
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain / psychology
  • Pain Management / psychology
  • Risk Factors
  • Severity of Illness Index
  • Young Adult