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Mood Disorders in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study
Journal article   Open access   Peer reviewed

Mood Disorders in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

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, …
Arthritis & rheumatology (Hoboken, N.J.), v 67(7), pp 1837-1847
Jul 2015
DOI: https://doi.org/10.1002/art.39111
PMID: 25778456
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1002/art.39111View
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Abstract

Adult Asians Autoantibodies - blood Blacks Cohort Studies Disease Progression Female Hispanic or Latino Humans Incidence Internationality Lupus Erythematosus, Systemic - ethnology Lupus Erythematosus, Systemic - immunology Lupus Erythematosus, Systemic - psychology Male Middle Aged Mood Disorders - epidemiology Mood Disorders - ethnology Mood Disorders - psychology Prospective Studies Quality of Life - psychology Regression Analysis Whites
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). 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. 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. 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.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Rheumatology
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