title: Role of psychosocial reserve capacity in anxiety and depression in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To examine the relationship between reserve capacity measures and anxiety/depression among patients with systemic lupus erythematosus (SLE) from Southern California (SoCal), United States and Manila, Philippines.
  
  
  METHODS
  A total of 235 participants with SLE completed self-reported scales to assess anxiety/depression and psychosocial reserve capacity measures (self-esteem, optimism, personal mastery/coping skills, social support), socioeconomic status (SES) data, and Mexican SLE Disease Activity Index. Statistical analyses included independent sample t-tests, Chi-square, and point-biserial and Pearson correlations.
  
  
  RESULTS
  Overall, participants from Manila reported lower SES than SoCal participants. Over half of Manila and SoCal participants (69% and 59.1%, respectively) reported high anxiety scores. SoCal participants had higher depression scores than Filipinos (66%, 27%, respectively, P < 0.001) despite appearing to be more resilient by exhibiting higher scores for all reserve capacity measures (P < 0.001). Participants with low self-esteem scores from both groups had higher anxiety and depression scores. SoCal participants who reported lower optimism, lower personal mastery and lower social support were more anxious and depressed, while Filipinos low on these three variables reported less depressive symptoms.
  
  
  CONCLUSIONS
  Reduced psychosocial reserve capacity in individuals leads to vulnerabilities that may ultimately result in greater disease burden and psychological distress. Low self-esteem, optimism, coping and social support were associated with depression and low self-esteem was associated with anxiety for both groups. Despite the Filipino cohort's lower reserve capacity and SES, Filipino patients exhibited less depression than their SoCal counterparts, suggesting that other factors may protect them from experiencing depression.
authors.affiliation: Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Zamora-Racaza
authors.affiliation: Department of Psychology, Loma Linda University, Loma Linda, California, USA.
authors.forename: Desiree R
authors.initials: DR
authors.lastname: Azizoddin
authors.affiliation: Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Mariko L
authors.initials: ML
authors.lastname: Ishimori
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine UCLA, Los Angeles, California, USA.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Ormseth
authors.affiliation: Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Wallace
authors.affiliation: Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines.
authors.forename: Ester G
authors.identifier: http://orcid.org/0000-0002-9192-6276
authors.initials: EG
authors.lastname: Penserga
authors.affiliation: Department of Psychology, Alliant University, Alhambra, California, USA.
authors.forename: Lekeisha
authors.initials: L
authors.lastname: Sumner
authors.affiliation: Post-baccalaureate Premedical Program, University of Southern California, Los Angeles, California, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Ayeroff
authors.affiliation: Department of Psychology, Loma Linda University, Loma Linda, California, USA.
authors.forename: Taylor
authors.initials: T
authors.lastname: Draper
authors.affiliation: Cousins Center for Psychoneuroimmunology, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Perry M
authors.initials: PM
authors.lastname: Nicassio
authors.affiliation: Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Weisman
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002140:California / Q000453:epidemiology; D058245:Cognitive Reserve; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D000067656:Optimism; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence; D065840:Protective Factors; D012307:Risk Factors; D012649:Self Concept; D057566:Self Report; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
keywords: anxiety; depression; reserve capacity; self-efficacy; social support; socioeconomic status; systemic lupus erythematosus