title: Psychological distress in corticosteroid-naive patients with systemic lupus erythematosus: A prospective cross-sectional study.
abstract: OBJECTIVE
  Psychological distress, such as depression and anxiety, has been intensively studied in patients with systemic lupus erythematosus (SLE). However, those studies have mostly included patients who were treated with corticosteroids, which might themselves induce mood disturbances. We investigated psychological distress in corticosteroid-naive patients with SLE who did not exhibit any overt neuropsychiatric manifestations.
  
  
  METHODS
  Forty-three SLE in-patients with no current or past abnormal neuropsychiatric history participated in the study. Patients and 30 healthy control subjects with similar demographic and personality characteristics were administered a comprehensive battery of psychological/neuropsychological tests. The Profile of Mood States (POMS) was used to assess depression and anxiety. Results of clinical, laboratory, and neurological tests were compared with regard to their presence.
  
  
  RESULTS
  Prevalence of depression was higher in patients (n = 11, 25.6%) than in controls (n = 2, 6.7%; p = 0.035), although prevalence of anxiety did not differ across groups (patients: 34.9%, n = 15; controls: 16.7%, n = 5; p = 0.147). Using multiple logistic regression analysis, we identified avoidance coping methods (OR, 1.3; 95% CI 1.030-1.644; p = 0.027) as an independent risk factor for depression.
  
  
  CONCLUSIONS
  Our results indicate that depression presents more frequently in corticosteroid-naive patients with early-stage, active SLE than in the normal population, but anxiety does not. Depression may be related to psychological reactions to suffering from the disease.
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan nishimura.katsuji@twmu.ac.jp.
authors.forename: K
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Kanagawa Psychiatric Center, Yokohama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Omori
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Katsumata
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Sato
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kawaguchi
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Harigai
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Ishigooka
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
keywords: Systemic lupus erythematosus; anxiety; corticosteroids; depression; psychological distress