A cross-sectional study on the association of anxiety and depression with the disease activity of systemic lupus erythematosus

Liao, Jiafen; Jin, Kang Hye; Li, Fen; Li, Qi; Wang, Jia; Tang, Qi; Mao, Ni; Li, Shu; Xie, Xiaoqing

doi:10.1186/s12888-022-04236-z

Cited by 16 publications

(25 citation statements)

References 22 publications

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“…22 Four epidemiological studies have assessed psychiatric comorbidities in patients with SLE as per the DSM-IV or DSM IV-TR, and the prevalence rate of the current study is comparable with these studies. [22][23][24][25] In the present study, the total number of individuals who screened positive for moderate, moderately severe and severe depression on PHQ-9 was approximately 39.8%, which corroborated with the clinically identified prevalence of depressive disorder in the group. We could not find any other study which attempted to assess patients of SLE for psychiatric based both on clinical interview and a validated screening instrument.…”

Section: Discussionsupporting

confidence: 87%

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Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Grover

Sahoo

Naskar

et al. 2023

Lupus

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Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease with multiorgan involvement presenting with a myriad of symptoms, including neuropsychiatric symptoms. Although many studies have evaluated screening questionnaires based psychiatric morbidity, very few studies have used contemporary diagnostic criteria. Objective This study aimed to evaluate the prevalence of psychiatric disorders in patients with SLE admitted to a tertiary care hospital. Methods A total of 79 patients diagnosed with SLE for at least for 1 year, who were not in delirium were assessed by a qualified psychiatrist for psychiatric morbidity as per the International Classification of Diseases, 10th Revision (ICD-10) criteria. Additionally, these patients were assessed on Patient Health Questionnaire-9 (PHQ-9) item version, Patient Health Questionnaire-15 (PHQ-15) item version, Generalized Anxiety Disorder-7 item scale and Montreal Cognitive Assessment (MoCA). Results 51% ( n = 40) of the participants were diagnosed with a psychiatric diagnosis, with depressive disorders being the most common, seen in 36.7% ( n = 29) of the participants. Additionally, 10% ( n = 8) participants were diagnosed with adjustment disorder and 2.5% ( n = 2) were diagnosed with anxiety (not otherwise specified). Only one patient was diagnosed with organic psychosis. On PHQ-9, 39.8% ( n = 33) were diagnosed with depression. 44.3% ( n = 35) expressed death wishes and/or suicidal ideations. On PHQ-15, 17.7% ( n = 14) of the participants scored for severe somatic distress (score >15). On GAD-7, 55.7% ( n = 44) screened positive for anxiety symptoms, but only 7.6% ( n = ) had a score of 15 or more to indicate severe anxiety. Nearly half ( n = 43; 52%) of the participants also had cognitive impairment as assessed on MoCA, with 13.3% ( n = 11) of the participants having scores indicating severe dementia. Conclusions Patients with SLE have a high prevalence of psychiatric comorbidities and should be routinely screened for psychiatric morbidity. They should be appropriately treated, to improve the overall treatment outcomes.

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Section: Discussionsupporting

confidence: 87%

“…A recent study used PHQ-9 as a screening tool for depression in SLE, and reported similar prevalence. 25 On PHQ-15, 17.7% of the participants scored for a severe somatic distress (score >15). We could not find any previous study attempting to quantify the somatic distress of patients with SLE.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Grover

Sahoo

Naskar

et al. 2023

Lupus

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“…Recent systematic reviews and meta-analyses suggest that the overall prevalence of depression and anxiety among SLE patients is 35%, respectively 25.8%, with ranges from 8.7% to 78.6% for depression and from 1.1% to 71.4% for anxiety, but the authors emphasize that the heterogeneity of the assessment’s scales used for these two majors neuropsychiatric SLE manifestations make challenging to identify a precise prevalence of anxiety and depression among SLE patients [ 9 ]. At the same time recent cross-sectional research results on SLE patients showed depression in 61.5% of patients and anxiety in 54.4% and suggested a cut-off value for SLEDAI of 8.5 for the increased risk of neuropsychiatric SLE manifestations [ 37 ]. This research indicates a strong correlation between depression symptoms and severe disability in social participation, interpersonal relationships and life abilities.…”

Section: Discussionmentioning

confidence: 99%

Association between Inflammation and Thrombotic Pathway Link with Pathogenesis of Depression and Anxiety in SLE Patients

et al. 2023

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As a complication of systemic lupus erythematosus (SLE), the neuropsychiatric form may manifest with neurological and psychiatric symptoms. Diagnosing neuropsychiatric SLE can be challenging due to the heterogeneity of this disease manifestation and the possibilities of investigation. This research aims to identify the possible associations between inflammation and thrombotic biomarkers alongside anxiety and/or depression manifestations in SLE patients. A group of 65 outpatients were investigated regarding the levels of depression, anxiety, disability, quality of life and other specific serum biomarkers linked with inflammation or coagulopathies. The results showed severe depression in eight participants, moderate depression in 22 (33.85%), and 26 (40%) subjects with mild depression. Anxiety was more prevalent within 64 participants (98.46%), while a degree of disability was reported by 52 participants (80%). Quality of life evaluated by EQ5D revealed a medium value of 1.57, and EQ5D VAS health medium value was 57.95 and was correlated with anxiety. A strong positive correlation between depression, anxiety and antibodies associated with anti-cardiolipin and anti beta2 glycoprotein I antibodies, lupus anticoagulant, ICAM-1, low C4 a and anti-ribosomal P antibodies were identified. These data results suggest that autoimmune/inflammatory and ischemic/thrombotic pathways could contribute to depression and anxiety as neuropsychiatric SLE manifestations.

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“…Neuropsychiatric symptoms of SLE are the most complex and severe manifestations of the disease, 17 with major depression being one of the most common manifestations and positively correlated with the disease activity index. 14,18 A growing…”

Section: Discussionmentioning

confidence: 99%

Lipidomics Changes in a Murine Model of Neuropsychiatric Lupus

Wang¹,

Ren²,

Hong³

et al. 2022

JIR

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Neuropsychiatric lupus (NPSLE) is one of the important manifestations of systemic lupus erythematosus. Previous studies mainly focused on the disruption of the blood-brain barrier and the production of brain-reactive autoantibodies, However, there is no comprehensive lipidomic analysis in NPSLE. Therefore, this research evaluated the lipidomic analysis in the hippocampus and liver of NPSLE mice with mood disorders, to explore the influence of the liver-brain axis on this disease. Methods: MRL/lpr mice and MRL/mpj mice were respectively used as NPSLE and control groups. Behavioral tests and systemic disease characteristics of mice were assessed at the age of 18 weeks. Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS) was used for lipid metabolite determination. Multivariate statistical analysis was used to identify lipid metabolites that were differentially expressed in two groups. Results: Our results showed that 355 and 405 lipid metabolites were differentially expressed between the NPSLE and control groups in the hippocampus and liver. According to the pathway enrichment analysis, several pathways were affected, and the glycerophospholipid metabolism pathway was most relevant to the mouse's depressive behavior. Conclusion:Based on UPLC-MS/MS, the results provide evidence for how the liver-brain axis affects NPSLE and improve the understanding of NPSLE pathogenesis.

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A cross-sectional study on the association of anxiety and depression with the disease activity of systemic lupus erythematosus

Cited by 16 publications

References 22 publications

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Association between Inflammation and Thrombotic Pathway Link with Pathogenesis of Depression and Anxiety in SLE Patients

Lipidomics Changes in a Murine Model of Neuropsychiatric Lupus

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