title: Illness perception in systemic lupus erythematosus patients: The roles of alexithymia and depression.
abstract: OBJECTIVE
  Alexithymia and depressive mood have been described as important dimensions of several medical diseases. Systemic lupus erythematosus is a chronic condition characterized by unpredictable clinical manifestations. The relationships between alexithymia, depression, and illness perception were examined in systemic lupus erythematosus patients. The interrelationships between psychological factors, such as alexithymia and depressive mood, were explored in systemic lupus erythematosus patients, and associations between these factors and illness perception in SLE were examined. We hypothesized that alexithymia and negative perceptions of illness would be associated in SLE patients, and depression would mediate this relationship.
  
  
  METHODS
  Subjects were 100 consecutive systemic lupus erythematosus patients attending the outpatient clinic at the University of Pisa rheumatology unit. They completed the Toronto Alexithymia Scale, Beck Depression Inventory, and Revised Illness Perceptions Questionnaire. Clinical variables were measured, disease activity was evaluated using the European Consensus Lupus Activity Measure, and damage was assessed using the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index.
  
  
  RESULTS
  There were no associations between clinical variables, alexithymia, and depression. The results highlight the existence of significant links between alexithymia and illness perception for systemic lupus erythematosus patients. Moreover, our data suggest that some of these links are mediated by depression, which is the direct predictor of different aspects of perceived health.
  
  
  CONCLUSIONS
  Our findings suggest that studying the role of psychological factors, such as alexithymia and depression, may contribute to a more comprehensive perspective of systemic lupus erythematosus, including their impact on patients' beliefs about treatment effectiveness and emotional adaptation to chronic disease.
authors.affiliation: Department of Psychology, University of Turin, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Barbasio
authors.affiliation: Rheumatology Unit, Department of Internal medicine, University of Pisa, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Vagelli
authors.affiliation: Department of Psychology, University of Turin, Italy; Department of social sciences and humanities, University of Aosta Valley, Italy. Electronic address: davide.marengo@unito.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Marengo
authors.affiliation: Rheumatology Unit, Department of Internal medicine, University of Pisa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Querci
authors.affiliation: Department of Psychology, University of Turin, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Settanni
authors.affiliation: Rheumatology Unit, Department of Internal medicine, University of Pisa, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Tani
authors.affiliation: Rheumatology Unit, Department of Internal medicine, University of Pisa, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Mosca
authors.affiliation: Department of Psychology, University of Turin, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Granieri
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D055809:Illness Behavior; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult