Major Depression and Adverse Patient‐Reported Outcomes in Systemic Lupus Erythematosus: Results From a Prospective Longitudinal Cohort

Dietz, Brett W.; Katz, Patricia P.; Dall’Era, Maria; Murphy, Louise B.; Lanata, Cristina; Trupin, Laura; Criswell, Lindsey A.; Yazdany, Jinoos

doi:10.1002/acr.24398

Cited by 30 publications

(36 citation statements)

References 33 publications

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“…Higher prevalence of major depression was found among Egyptian SLE (64%) which was related to disease activity, not to steroids or duration of illness [43]. Depression worsens fatigue, discomfort, and psychological distress in SLE patients, as well as lowering adherence to drugs, resulting in a considerable reduction in quality of life [44].…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric lupus erythematosus in a cohort of Egyptian patients

Ragab

Ibrahim

2022

Egypt J Neurol Psychiatry Neurosurg

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Background The neuropsychiatric lupus erythematosus (NPSLE) is a severe complication of systemic lupus erythematosus (SLE) that is characterized by a variety of neurological manifestations involving both central and peripheral nervous system with variable mechanisms. This study aimed to investigate the frequency of NPSLE and its relation to other clinical and laboratory findings in SLE patients. Results We retrieved the medical records of 134 SLE patients during the study period; of them, 68 patients (50.7%) had NPSLE. Headache (55. 9%) was the most frequent NPSLE manifestation followed by seizures (54.4%), psychosis was the third most frequent one with a percentage of 41.2. The demographic data didn’t differ in patients with and without NPSLE. NPSLE patients had lower complement 3 (C3) (p = 0.025) and C4 (p = 0.008) levels, more lupus anticoagulant level (p = 0.033) and more frequency of antiphospholipid syndrome (p = 0.030). There was no statistical difference regarding the drug intake or other laboratory findings. Disease activity and damage indices didn’t differ in both groups. Conclusion The prevalence of NPSLE in this study was 50.7%. Headache, seizures and psychosis were the most frequent neuropsychiatric manifestations in the studied patients. SLE patients with neuropsychiatric manifestations had lower complement levels, higher lupus anticoagulant antibodies and antiphospholipid syndrome.

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Section: Discussionmentioning

confidence: 99%

Neuropsychiatric lupus erythematosus in a cohort of Egyptian patients

Ragab

Ibrahim

2022

Egypt J Neurol Psychiatry Neurosurg

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“…A previous study reported a link between major depression in SLE and lower HRQoL [20]. However, details of the relationship, in particular the effects of depression on domains of the HRQoL are not well understood [21]. The present study aimed to determine the impact of major depression on the quality of life of SLE-relevant health domains and to evaluate other possible risk factors that can affect the quality of life.…”

Section: Introductionmentioning

confidence: 95%

Impact of depression on quality of life in systemic lupus erythematosus patients

Khedr

Gamal

Rashad

et al. 2021

Egypt J Neurol Psychiatry Neurosurg

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Background Depression is common in systemic lupus erythematosus (SLE) and is an unmeasured risk factor, yet its symptoms can be neglected in standard disease evaluations. The purpose of this study was to assess the frequency and the impact of depression on quality of life in SLE patients. We recruited 32 patients with SLE and 15 healthy control volunteers in the study. The following investigations were undertaken in each patient: clinical and rheumatologic assessment, SLE Disease Activity Index-2k (SLEDAI-2k), Beck Depression Inventory (BDI), Short-Form Health Survey (SF-36) questionnaire, and routine laboratory tests. Results There was a high percentage of depression (46.9%) in the SLE patients. Regarding quality of life (SF-36), there were significant affection of the physical and mental composite summary domains (PCS and MCS) scores in lupus patients compared with controls (P < 0.000 for both) with the same significant in depressed compared with non-depressed patients. SF-36 subscales (physical function, limit emotional, emotional wellbeing, and social function) were significantly affected in depressed lupus patients compared with non-depressed patients. There was a significant negative correlation between the score of MCS domain of SF-36 with BDI (P < 0.000) while positive correlation between SLEDAI score with depression score. In contrast, there were no significant correlations between MCS or PCS with age, duration of illness, or SLEDAI-2K. Conclusions Depression is common in SLE patients and had a negative impact on quality of life particularly on MCS domain and positive correlation with disease severity score. Trial registration This study was registered on clinical trial with registration number: NCT03165682 https://clinicaltrials.gov/ct2/show/NCT03165682 on 24 May 2017.

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“…[ 6 ] Depression in SLE has been directly associated with medication non-adherence, resulting in objective measures of increased disease activity as well as worse patient reported outcomes in multiple domains. [ 3 , 7 ]…”

Section: Introductionmentioning

confidence: 99%

Targeted provider education and pre-visit planning increase rates of formal depression screening in childhood-onset SLE

et al. 2021

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Background Despite being at high risk for depression, patients with childhood-onset systemic lupus erythematosus (c-SLE) are infrequently and inconsistently screened for depression by their pediatric rheumatologists. We aimed to systematically increase rates of formal depression screening for c-SLE patients in an academic Pediatric Rheumatology clinic. Methods Our multi-disciplinary quality improvement (QI) team used electronic health record (EHR) documentation to retroactively calculate baseline rates of documented depression screening using the Patient Health Questionnaire-9 (PHQ-9). We then engaged key stakeholders to develop a clinical workflow for formal depression screening in the clinic. We also provided education to providers regarding mental health disorders in c-SLE, with an emphasis on prevalence, screening methods, and management of positive screens. We then used the Plan-Do-Study Act (PDSA) method of QI to systematically evaluate and adjust our process in real time. The primary outcome was the percentage of patients with c-SLE seen per month who had a documented PHQ-9 screening within the past year. Results The percentage of children with documented PHQ-9 results ranged from 0 to 4.5 % at baseline to 91.0 % within 12 months of project initiation. By the end of the project, monthly screening rates greater than 80 % has been sustained for 10 months. As a result of these efforts, twenty-seven (48.2 %) patients with at least mild depressive symptoms were identified while seven (12.5 %) with thoughts of self-harm were referred to appropriate mental health resources. Conclusions Routine formal depression screening is feasible in a busy subspecialty clinic. Using QI methods, rates of formal depression screening among children with c-SLE were increased from an average of 3.3 % per month to a sustained monthly rate of greater than 80 %. Individuals with depressive symptoms and/or thoughts of self-harm were identified and referred to appropriate mental health resources.

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Major Depression and Adverse Patient‐Reported Outcomes in Systemic Lupus Erythematosus: Results From a Prospective Longitudinal Cohort

Cited by 30 publications

References 33 publications

Neuropsychiatric lupus erythematosus in a cohort of Egyptian patients

Neuropsychiatric lupus erythematosus in a cohort of Egyptian patients

Impact of depression on quality of life in systemic lupus erythematosus patients

Targeted provider education and pre-visit planning increase rates of formal depression screening in childhood-onset SLE

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