Cardiovascular and Disease-Related Predictors of Depression in Systemic Lupus Erythematosus

Department of Medicine, University of California, San Francisco, 3333 California Street, Suite 270, San Francisco, CA 94143-0920, USA.
Arthritis care & research 04/2011; 63(4):542-9. DOI: 10.1002/acr.20426
Source: PubMed


Depression and cardiovascular disease are common and debilitating comorbidities associated with systemic lupus erythematosus (SLE). In this study, history of cardiovascular events, cardiovascular risk factors, and SLE disease-related factors were evaluated as longitudinal predictors of depression in a large cohort of patients with SLE.
Data were derived from 663 adult participants in the 2004-2008 Lupus Outcomes Study, who were followed for up to 5 annual interviews. Multivariate logistic regression analyses using generalized estimating equations were used to determine predictors of the development of increased depressive symptom severity over a 12-month period (Center for Epidemiologic Studies Depression Scale [CES-D] score of 23 or greater), yielding 2,224 paired observations. Predictors included sociodemographics, traditional cardiovascular risk factors (reported presence of heart disease, history of stroke or myocardial infarction, hypertension, hypercholesterolemia, diabetes mellitus, obesity, smoking status, and family history), and SLE-specific risk factors (glucocorticoid use, renal involvement, disease duration, and disease activity).
The annual incidence of depression was 12% in this cohort. Multivariate predictors of new-onset depression included younger age (ages 20-39 years: odds ratio [OR] 2.3, 95% confidence interval [95% CI] 1.3-3.9; ages 40-59 years: OR 1.8, 95% CI 1.1-2.7), Hispanic/Latino ethnicity (OR 1.8, 95% CI 1.2-2.8), having some college education (OR 1.8, 95% CI 1.1-3.0), baseline CES-D score (OR per point 1.1, 95% CI 1.1-1.2), presence of diabetes mellitus (OR 1.8, 95% CI 1.1-2.8), and baseline SLE disease activity (OR 1.2, 95% CI 1.1-1.4).
These results suggest that, in addition to known sociodemographic factors, the presence of diabetes mellitus and SLE disease activity may play a role in the development of depression in SLE.

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Available from: Patricia P Katz, May 28, 2014
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    • "Associations between depression and disease activity are also inconsistent because of methodological difference in measuring disease activity of SLE[2,262728. Using the objective disease activity measure such as SLEDAI there was no association between depression and disease activity[2,2728, whereas using the subjective disease activity measure such as systemic lupus activity questionnaire (SLAQ), disease activity was shown to be associated with depression[2,26,27]. In the current study, PGA, the subjective disease activity measure by patients' perspective was significantly associated with depression while SLEDAI, the objective disease activity measure was not associated with depression in accordance with previous researches. "
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