John G Hanly1, Li Su2, Murray B Urowitz3, Juanita Romero-Diaz4, Caroline Gordon5, Sang-Cheol Bae6, Sasha Bernatsky7, Ann E Clarke8, Daniel J Wallace9, Joan T Merrill10, David A Isenberg11, Anisur Rahman11, Ellen M Ginzler12, Michelle Petri13, Ian N Bruce14, M A Dooley15, Paul Fortin16, Dafna D Gladman3, Jorge Sanchez-Guerrero3, Kristjan Steinsson17, Rosalind Ramsey-Goldman18, Munther A Khamashta19, Cynthia Aranow20, Graciela S Alarcón21, Barri J Fessler21, Susan Manzi22, Ola Nived23, Gunnar K Sturfelt23, Asad A Zoma24, Ronald F van Vollenhoven25, Manuel Ramos-Casals26, Guillermo Ruiz-Irastorza27, S Sam Lim28, Kenneth C Kalunian29, Murat Inanc30, Diane L Kamen31, Christine A Peschken32, Soren Jacobsen33, Anca Askanase34, Chris Theriault1, Kara Thompson1, Vernon Farewell2. 1. Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada. 2. Institute of Public Health and University of Cambridge, University Forvie Site, Cambridge, UK. 3. Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. 4. Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico. 5. University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK. 6. Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea. 7. McGill University Health Centre, Montreal, Quebec, Canada. 8. University of Calgary, Calgary, Alberta, Canada. 9. Cedars-Sinai Medical Center and University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California. 10. Oklahoma Medical Research Foundation, Oklahoma City. 11. University College London, London, UK. 12. State University of New York Downstate Medical Center, Brooklyn. 13. Johns Hopkins University, Baltimore, Maryland. 14. Manchester Academic Health Sciences Centre, University of Manchester, and Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK. 15. University of North Carolina, Chapel Hill. 16. Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, Quebec, Canada. 17. Landspitali University Hospital, Reykjavik, Iceland. 18. Northwestern University and Feinberg School of Medicine, Chicago, Illinois. 19. The Rayne Institute, St. Thomas' Hospital, and King's College London School of Medicine, London, UK. 20. Feinstein Institute for Medical Research, Manhasset, New York. 21. University of Alabama at Birmingham. 22. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 23. University Hospital Lund, Lund, Sweden. 24. Lanarkshire Centre for Rheumatology and Hairmyres Hospital, East Kilbride, UK. 25. Karolinska Institute, Stockholm, Sweden. 26. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain. 27. Hospital de Cruces and University of the Basque Country, Barakaldo, Spain. 28. Emory University, Atlanta, Georgia. 29. University of California at San Diego, La, Jolla. 30. Istanbul University, Istanbul, Turkey. 31. Medical University of South Carolina, Charleston. 32. University of Manitoba, Winnipeg, Manitoba, Canada. 33. Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 34. New York University, New York, New York.
Abstract
OBJECTIVE: To examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. RESULTS: Among the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean ± SD age of the patients was 35.1 ± 13.3 years, disease duration was 5.6 ± 4.8 months, and the length of followup was 4.7 ± 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P ≤ 0.01), and a lower risk was associated with Asian race/ethnicity (P = 0.01) and treatment with immunosuppressive drugs (P = 0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. CONCLUSION: Mood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.
OBJECTIVE: To examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. RESULTS: Among the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean ± SD age of the patients was 35.1 ± 13.3 years, disease duration was 5.6 ± 4.8 months, and the length of followup was 4.7 ± 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P ≤ 0.01), and a lower risk was associated with Asian race/ethnicity (P = 0.01) and treatment with immunosuppressive drugs (P = 0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. CONCLUSION: Mood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.
Authors: R L Brey; S L Holliday; A R Saklad; M G Navarrete; D Hermosillo-Romo; C L Stallworth; C R Valdez; A Escalante; I del Rincón; G Gronseth; C B Rhine; P Padilla; D McGlasson Journal: Neurology Date: 2002-04-23 Impact factor: 9.910
Authors: Suetonia Palmer; Mariacristina Vecchio; Jonathan C Craig; Marcello Tonelli; David W Johnson; Antonio Nicolucci; Fabio Pellegrini; Valeria Saglimbene; Giancarlo Logroscino; Steven Fishbane; Giovanni F M Strippoli Journal: Kidney Int Date: 2013-03-13 Impact factor: 10.612
Authors: Wilmer L Sibbitt; John R Brandt; Courtney R Johnson; Marcos E Maldonado; Samir R Patel; Corey C Ford; Arthur D Bankhurst; William M Brooks Journal: J Rheumatol Date: 2002-07 Impact factor: 4.666
Authors: D Gladman; E Ginzler; C Goldsmith; P Fortin; M Liang; M Urowitz; P Bacon; S Bombardieri; J Hanly; E Hay; D Isenberg; J Jones; K Kalunian; P Maddison; O Nived; M Petri; M Richter; J Sanchez-Guerrero; M Snaith; G Sturfelt; D Symmons; A Zoma Journal: Arthritis Rheum Date: 1996-03
Authors: J G Hanly; M B Urowitz; L Su; J Sanchez-Guerrero; S C Bae; C Gordon; D J Wallace; D Isenberg; G S Alarcón; J T Merrill; A Clarke; S Bernatsky; M A Dooley; P R Fortin; D Gladman; K Steinsson; M Petri; I N Bruce; S Manzi; M Khamashta; A Zoma; J Font; R Van Vollenhoven; C Aranow; E Ginzler; O Nived; G Sturfelt; R Ramsey-Goldman; K Kalunian; J Douglas; K Qiufen Qi; K Thompson; V Farewell Journal: Arthritis Rheum Date: 2008-05-15
Authors: S Tiosano; A Farhi; A Watad; N Grysman; R Stryjer; H Amital; D Comaneshter; A D Cohen; D Amital Journal: Epidemiol Psychiatr Sci Date: 2016-07-26 Impact factor: 6.892
Authors: John G Hanly; Qiuju Li; Li Su; Murray B Urowitz; Caroline Gordon; Sang-Cheol Bae; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; David A Isenberg; Anisur Rahman; Joan T Merrill; Paul Fortin; Dafna D Gladman; Ian N Bruce; Michelle Petri; Ellen M Ginzler; M A Dooley; Kristjan Steinsson; Rosalind Ramsey-Goldman; Asad A Zoma; Susan Manzi; Ola Nived; Andreas Jonsen; Munther A Khamashta; Graciela S Alarcón; Winn Chatham; Ronald F van Vollenhoven; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; Manuel Ramos-Casals; S Sam Lim; Murat Inanc; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Diane L Kamen; Anca Askanase; Chris Theriault; Vernon Farewell Journal: Arthritis Care Res (Hoboken) Date: 2018-09-01 Impact factor: 4.794
Authors: John G Hanly; Li Su; Murray B Urowitz; Juanita Romero-Diaz; Caroline Gordon; Sang-Cheol Bae; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; Joan T Merrill; David A Isenberg; Anisur Rahman; Ellen M Ginzler; Michelle Petri; Ian N Bruce; M A Dooley; Paul Fortin; Dafna D Gladman; Jorge Sanchez-Guerrero; Kristjan Steinsson; Rosalind Ramsey-Goldman; Munther A Khamashta; Cynthia Aranow; Graciela S Alarcón; Barri J Fessler; Susan Manzi; Ola Nived; Gunnar K Sturfelt; Asad A Zoma; Ronald F van Vollenhoven; Manuel Ramos-Casals; Guillermo Ruiz-Irastorza; S Sam Lim; Kenneth C Kalunian; Murat Inanc; Diane L Kamen; Christine A Peschken; Soren Jacobsen; Anca Askanase; Chris Theriault; Vernon Farewell Journal: Arthritis Rheumatol Date: 2016-08 Impact factor: 10.995
Authors: John G Hanly; Caroline Gordon; Sang-Cheol Bae; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; David A Isenberg; Anisur Rahman; Joan T Merrill; Paul R Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; Michelle Petri; Ellen M Ginzler; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Andreas Jonsen; Graciela S Alarcón; Ronald F van Vollenhoven; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Diane L Kamen; Anca Askanase; Vernon Farewell Journal: Arthritis Rheumatol Date: 2021-10-29 Impact factor: 15.483