Subscale analysis of quality of life in patients with systemic lupus erythematosus: association with depression, fatigue, disease activity and damage.
OBJECTIVE
The quality of life (QoL) in systemic lupus erythematosus (SLE) patients may be affected by psychological features and disease status. We evaluated the QoL of SLE patients according to four subscales of QoL compared to healthy controls, and the association with affecting factors.


METHODS
108 patients with SLE and 52 healthy controls completed a psychological questionnaire. Depression, fatigue, and QoL were assessed with the Centre for Epidemiologic Studies Depression Scale, the Profile of Mood States Fatigue-Inertia Scale, and Functional Assessment Chronic Illness Therapy. Disease activity and damage index were measured by the SLE Disease Activity Index and SLE Collaborating Clinics/American College of Rheumatology.


RESULTS
SLE patients showed higher degrees of depression (p=0.005) and a lower total QoL score than the controls (p=0.003). In the subscale analysis, physical well-being (PWB) and emotional well-being (EWB) were lower in the SLE group than the control group (p<0.001 for both). Multivariate analysis identified correlations between the following factors: total QoL with depression and daily glucocorticoid dose; PWB with depression, fatigue, and daily glucocorticoid; EWB with depression and functional well-being (FWB) with depression.


CONCLUSIONS
The QoL of SLE patients was lower than that of healthy controls. QoL subscales of the SLE patients were associated with daily glucocorticoid dose, depression, and fatigue rather than disease activity or damage. Comprehensive evaluation of psychological problems and appropriate management may improve the QoL of SLE patients, especially those using higher doses of glucocorticoids, even if disease activity and damage are not severe.
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea. beconst@hanmail.net
Sang Tae
ST
Choi
Jee In
JI
Kang
Il-Ho
IH
Park
Yong Won
YW
Lee
Jung-Soo
JS
Song
Yong-Beom
YB
Park
Soo-Kon
SK
Lee
D000328:Adult; D000339:Affect; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004644:Emotions; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D016014:Linear Models; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D005938:Glucocorticoids