Dong-Jin Park1, Ji-Hyoun Kang1, Kyung-Eun Lee1, Seong Wook Kang2, Seung-Ki Kwok3, Seong-Kyu Kim4, Jung-Yoon Choe4, Hyoun-Ah Kim5, Yoon-Kyoung Sung6, Kichul Shin7, Sang-Il Lee8, Chang-Hoon Lee9, Sung-Jae Choi10, Shin-Seok Lee11. 1. Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea. 2. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. 3. Division of Rheumatology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 4. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. 5. Department of Rheumatology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea. 6. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. 7. Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea. 8. Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Gyeongnam, Korea. 9. Division of Rheumatology, Dept. of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea. 10. Division of Rheumatology, Dept. of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. 11. Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea. shinseok@chonnam.ac.kr.
Abstract
OBJECTIVES: Depression is more common in patients with systemic lupus erythematosus (SLE) compared to the general population. However, few studies have investigated risk factors of depression in SLE patients, and the results are inconsistent. This study evaluated the prevalence of, and risk factors for, depression in ethnically homogeneous Korean SLE patients. METHODS: In this study, 505 consecutive SLE patients were enrolled from the Korean Lupus Network registry. Demographic variables, clinical manifestations, laboratory findings, physician global assessment, and SLEDAI-2000 and SLICC damage index were recorded at enrolment. Patients were identified as having depressive symptoms using the Korean version of the Beck Depression Inventory (BDI) with a cut-off ≥16, and categorised into four groups. Multivariable logistic regression analyses were performed to identify independent risk factors for depression defined as a BDI score ≥16. RESULTS: Of the 505 patients, 97 (19.2%) were diagnosed with depression. Patients with a higher BDI score were older, more likely to be a current smoker, and had a SLICC score >1. Conversely, they had lower income and educational levels. Regarding the serologic findings, patients with a higher BDI score had lower anti-double-stranded DNA positivity and higher anticardiolipin (aCL) positivity. On multivariate analysis, the following factors were associated with depression: current smoking status (OR 2.533, p=0.049), aCL-positivity (OR 2.009, p=0.035), and a SLICC damage index score >1 (OR 2.781, p=0.039). On the other hand, high-level education (OR 0.253, p=0.024) and a high income (OR 0.228, p=0.008) were negatively associated with depression. CONCLUSIONS: Our results show that depression is prevalent in patients with SLE and multiple factors are associated with depression in SLE. These data could help guide target programmes for those at high risk of depression in SLE.
OBJECTIVES:Depression is more common in patients with systemic lupus erythematosus (SLE) compared to the general population. However, few studies have investigated risk factors of depression in SLEpatients, and the results are inconsistent. This study evaluated the prevalence of, and risk factors for, depression in ethnically homogeneous Korean SLEpatients. METHODS: In this study, 505 consecutive SLEpatients were enrolled from the Korean Lupus Network registry. Demographic variables, clinical manifestations, laboratory findings, physician global assessment, and SLEDAI-2000 and SLICC damage index were recorded at enrolment. Patients were identified as having depressive symptoms using the Korean version of the Beck Depression Inventory (BDI) with a cut-off ≥16, and categorised into four groups. Multivariable logistic regression analyses were performed to identify independent risk factors for depression defined as a BDI score ≥16. RESULTS: Of the 505 patients, 97 (19.2%) were diagnosed with depression. Patients with a higher BDI score were older, more likely to be a current smoker, and had a SLICC score >1. Conversely, they had lower income and educational levels. Regarding the serologic findings, patients with a higher BDI score had lower anti-double-stranded DNA positivity and higher anticardiolipin (aCL) positivity. On multivariate analysis, the following factors were associated with depression: current smoking status (OR 2.533, p=0.049), aCL-positivity (OR 2.009, p=0.035), and a SLICC damage index score >1 (OR 2.781, p=0.039). On the other hand, high-level education (OR 0.253, p=0.024) and a high income (OR 0.228, p=0.008) were negatively associated with depression. CONCLUSIONS: Our results show that depression is prevalent in patients with SLE and multiple factors are associated with depression in SLE. These data could help guide target programmes for those at high risk of depression in SLE.
Authors: Connor D Martz; Evelyn A Hunter; Michael R Kramer; Yijie Wang; Kara Chung; Michael Brown; Cristina Drenkard; S Sam Lim; David H Chae Journal: Health Place Date: 2021-06-09 Impact factor: 4.931