title: Depressive symptoms and associated factors in systemic lupus erythematosus.
abstract: BACKGROUND
  Depressive symptoms affect anywhere from 11% to 71% of patients with systemic lupus erythematosus (SLE), which may be related to SLE disease activity, other clinical variables, or sociodemographic factors.
  
  
  OBJECTIVE
  We aimed to measure the rate of depressive symptoms in our cohort of patients with SLE and to identify modifiable factors associated with depressive symptoms.
  
  
  METHODS
  Patients in our university-based SLE registry completed the Beck Depression Inventory-II (BDI-II), pain scores, and demographic information. Disease activity was measured using the physician's global assessment (PGA) and Selena-SLE disease activity index (Selena-systemic lupus erythematosus disease activity index (SLEDAI)). Patients were identified as having moderate or severe depressive symptoms (BDI-II ≥ 18) or not (BDI-II < 18). Nonparametric tests and χ(2) tests were used as appropriate to compare variables between groups.
  
  
  RESULTS
  Fifty-three of 127 people (41.7%) were identified as having moderate or severe depressive symptoms, which were associated with higher pain levels and lower self-reported of current health status. Patients with moderate or severe depressive symptoms were more likely (49%) than those with no or mild depressive symptoms (18%) to have lupus arthritis (P < 0.01). Of the 53 patients with moderate or severe depressive symptoms, only 26 (49.0%) were prescribed antidepressants, and only 8/53 patients (15.0%) were prescribed the maximum dose of antidepressant.
  
  
  CONCLUSIONS
  This study identified moderate or severe depressive symptoms in 41.7% of our cohort of patients with SLE. The most significant variable associated with these symptoms was pain; improved treatment of pain, and in particular from lupus arthritis, may result in alleviation of depressive symptoms in patients with SLE.
authors.affiliation: Duke University Medical Center, Durham, NC.
authors.forename: David E
authors.initials: DE
authors.lastname: Karol
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Criscione-Schreiber
authors.forename: Min
authors.initials: M
authors.lastname: Lin
authors.forename: Megan E B
authors.initials: ME
authors.lastname: Clowse
mesh_terms: D000328:Adult; D001168:Arthritis / Q000209:etiology / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology; D059408:Pain Management / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult