Psychosocial research on systemic lupus erythematosus: a literature review

Seawell, Asani H.; Danoff–Burg, Sharon

doi:10.1191/0961203304lu1083rr

Cited by 76 publications

(85 citation statements)

References 63 publications

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“…Furthermore, the impact of therapy on psychosocial aspects (depression, anxiety, perceived vulnerability to stress, perceived health) and QOL may have implications for longer-term health behaviours and health outcomes. Therefore, it is essential that stress, its psychological consequences and its negative impact on the lives of the patients are taken into consideration [27,29,51]. These preliminary results should be verified in further studies.…”

Section: Discussionmentioning

confidence: 99%

“…Anxiety and depression, which are frequently caused by daily stress, are the most prevalent psychological disorders experienced by lupus patients, affecting up to 40% of patients in some series [26,27,28]. Furthermore, it is evident that lupus patients are dissatisfied with the treatment of both these disorders [29], indicating that lupus is currently being mismanaged and that patients’ concerns are not being dealt with adequately.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Navarrete‐Navarrete

Peralta-Ramírez

Sabio-Sánchez

et al. 2010

Psychother Psychosom

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Background: Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. Methods: Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. Results: We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. Conclusions: CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients’ QOL, despite there being no significant reduction in the disease activity index.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Navarrete‐Navarrete

Peralta-Ramírez

Sabio-Sánchez

et al. 2010

Psychother Psychosom

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“…Few studies have investigated treatment adherence in SLE patients and generalization of the results is often limited because rheumatoid arthritis (RA) and SLE patients were treated as one patient group (2,8,9) or differences between specific ethnic groups were investigated (1,2,8 -10). Moreover, psychosocial factors that may predict treatment adherence in SLE patients have not been sufficiently investigated (11). The present study aimed at assessing treatment adherence in a representative cohort of SLE patients and investigating associations with psychosocial and medical factors.…”

Section: Introductionmentioning

confidence: 99%

Intentional and unintentional treatment nonadherence in patients with systemic lupus erythematosus

Daleboudt¹,

Broadbent²,

McQueen³

et al. 2011

Arthritis Care & Research

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Objective. Patients may be defined as nonadherent if they do not take their medications as prescribed by their physicians. Determinants of nonadherence may vary between and within patient groups. This study investigated the extent to which patients with systemic lupus erythematosus (SLE) show intentional and unintentional nonadherence, and the associations of nonadherence with psychological and medical parameters. Methods. The study included 106 patients who were receiving at least one immunosuppressive agent to control their SLE. Level of self-reported adherence and a measure of both intentional and unintentional nonadherence were obtained. Questionnaires were completed to assess associations between adherence and problems with cognitive functioning, beliefs about medicines, illness perceptions, emotional health, and disease characteristics. Results. The mean self-reported adherence rate for the total patient group was 86.7%. At least occasional intentional nonadherence was reported by 46.2% of patients and 58.5% of patients were at least occasionally unintentionally nonadherent. Problems with cognitive functioning, concerns about adverse effects of medication, and younger age were the strongest predictors of (non)adherence. Patients who were emotionally affected by their SLE were more likely to report low adherence, but this was not a significant predictor after accounting for other variables. Disease characteristics showed no relationship to measures of adherence. Conclusion. Although SLE patients reported high levels of adherence on average, they commonly reported intentional and unintentional nonadherence. Adherence was associated with both cognitions and emotions. Nonadherence may be reduced by targeting emotional and cognitive functioning and by fine tuning doctor-patient communication to address patients' individual concerns about their medications.

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“…For example, neuropsychiatric abnormalities may reflect direct effects of the disease or side effects of medications used to treat SLE, such as high-dosage steroids. Yet it is difficult to determine whether psychosocial problems preceded or were precipitated by the disease [3,4] .…”

Section: Introductionmentioning

confidence: 99%

“…Others have described, in a global manner, the relationships between psychosocial factors and morbidity [for review, see 4 ]. There are 3 aspects of morbidity in SLE: SLE activity, SLE disease damage and quality of life [3,4] . SLE activity and disease damage are assessed objectively with instruments that take into account several clinical and paraclinical variables.…”

Section: Introductionmentioning

confidence: 99%

Stress and Coping Strategies in Systemic Lupus Erythematosus: A Review

Bricou

Taïeb

Baubet

et al. 2006

Neuroimmunomodulation

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Systemic lupus erythematosus (SLE), a chronic and unpredictable disease accompanied by functional disability and a possible involvement of the central nervous system, leads to considerable psychological distress. A review of studies on stress and/or coping strategies in SLE since 1990 is presented. Many studies have investigated the place of major and minor stress and coping strategies in SLE morbidity (disease activity, organ damage, and physical and mental components of quality of life). Stress as a causal factor is not proved, but it seems to act as an exacerbating factor in disease activity and to have an impact on the quality of life. Coping strategies are more consistently associated with quality of life than with disease activity. Organ damage appears to be less associated with psychosocial factors than disease activity or quality of life. Despite the limitations of these studies, therapeutic interventions should be proposed to reduce psychological distress, to improve the quality of life and possibly to moderate the evolution of the disease.

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Psychosocial research on systemic lupus erythematosus: a literature review

Cited by 76 publications

References 63 publications

Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Intentional and unintentional treatment nonadherence in patients with systemic lupus erythematosus

Stress and Coping Strategies in Systemic Lupus Erythematosus: A Review

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