title: Psychosocial correlates of morbidity in women with systemic lupus erythematosus.
abstract: OBJECTIVE
  Modifiable psychosocial factors that are associated with health outcomes may provide new opportunities for treatment. We investigated the associations of various psychosocial factors with 3 measures of morbidity in women with systemic lupus erythematosus (SLE).
  
  
  METHODS
  We collected information on 16 social, psychological, behavioral, and medical care factors in a cross sectional survey of 100 women with SLE, and related these to measures of physical disability (assessed by the Health Assessment Questionnaire Disability Index), SLE activity (assessed by the Systemic Lupus Activity Measure), and cumulative organ damage (assessed by the SLICC/ACR Damage Index).
  
  
  RESULTS
  In multivariate analyses, greater physical disability was significantly associated with higher depression scale scores and higher body mass indexes. Greater SLE activity was associated with less adequate social support. Greater cumulative organ damage was associated with lower self-esteem and a time orientation that favored the present over the future. Financial barriers to medical care, knowledge about SLE, health locus of control, marital status, and health behaviors including compliance with medications, smoking, alcohol use, and exercise, were not significantly associated with any measure of morbidity.
  
  
  CONCLUSIONS
  Selected psychosocial factors are associated with morbidity in SLE, but differ with the measure of morbidity examined.
authors.affiliation: Medical Service, VA Palo Alto Health Care System, CA 94304, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Ward
authors.forename: D S
authors.initials: DS
authors.lastname: Lotstein
authors.forename: T M
authors.initials: TM
authors.lastname: Bush
authors.forename: R E
authors.initials: RE
authors.lastname: Lambert
authors.forename: R
authors.initials: R
authors.lastname: van Vollenhoven
authors.forename: C M
authors.initials: CM
authors.lastname: Neuwelt
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000523:psychology*; D009017:Morbidity; D015999:Multivariate Analysis; D012944:Social Support