The influence of anxiety and depression on Korean lupus patients’ quality of life
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Abstract
Background & Aim: Approximately 40% of lupus patients experience anxiety and depression. This study aimed to determine the effects of anxiety and depression on lupus patients’ quality of life.
Methods & Materials: This study adopted a correlational predictive survey design. Using convenience sampling, we recruited 117 patients who had been diagnosed with lupus at a general tertiary hospital in Korea. Structured questionnaires were used to assess their demographic and clinical characteristics, the Hospital Anxiety and Depression Scale, and Lupus Quality of Life. Data analyses included descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation analysis, and stepwise multiple regression analysis and were performed with the SAS program (version 9.4).
Results: The participants obtained a mean overall quality of life score of 63.49 out of 100. The highest and lowest means emerged for physical health and burden to others, respectively. Anxiety emerged as the strongest predictor of quality of life, followed by disease activity, depression, and disease duration. These variables explained 53 % of the variance in lupus patients’ quality of life.
Conclusion: Medical professionals should pay close attention to each lupus patient's disease activity and duration to improve his or her quality of life. In particular, multidisciplinary efforts are needed to take proactive steps to screen for anxiety and depression in lupus patients.
1. Yilmaz-Oner S, Oner C, Dogukan FM, Moses TF, Demir K, Tekayev N, Yilmaz N, Tuglular S, Direkemeli H. Anxiety and depression predict quality of life in Turkish patients with systemic lupus erythematous. Clinical and Experimental Rheumatology. 2015 May-Jun;33(3):360-5.
2. Bae EH, Lim SY, Han KD, Jung JH, Choi HS, Kim HY, Kim CS, Ma SK, Kim SW. Trend of prevalence and incidence of systemic lupus erythematosus in South Korea, 2005 to 2015: a nationwide population-based study. Korean Journal of Internal Medicine. 2020 May;35(3):652-61. doi: 10.3904/kjim.2018.303.
3. Larsen. JL, Hall EOC, Jacobsen S, Birkelund R. The existential experience of everyday life with systemic lupus erythematosus. Journal of Advanced Nursing.2018;74:1170-9. doi:10.1111/jan.13525
4. Hyphantis T, Palieraki K, Voulgari PV, Tsifetaki N, Drosos AA. Coping with health-stressors and defence styles associated with health-related quality of life in patients with systemic lupus erythematosus. Lupus. 2011 Aug;20(9):893-903. doi: 10.1177/0961203311398264.
5. Schmeding A, Schneider M. Fatigue, health-related quality of life and other patient-reported outcomes in systemic lupus erythematosus. Best Practice & Research and Clinical Rheumatology. 2013 Jun;27(3):363-75. doi: 10.1016/j.berh.2013.07.009.
6. Etchegaray-Morales I, Meindez-Martinez S, Jimenez-Hernández C, Mendoza-Pinto C, Alonso-Garcia NE, Montiel-Jarquin A, Lopez-Colombo A, Garcia-Villaserior A, Cardiel MH, Garcia-Carrasco M. Factors associated with health-related quality of life in Mexican lupus patients using the lupusqol. Public Library of Science ONE. 2017 Jan;12(1):e0170209. doi: 10.1371/journal.pone.0170209.
7. McElhone K, Abbott J, Gray J, Williams A, Teh LS. Patient perspective of systemic lupus erythematosus in related to health-related quality of life concepts: A qualitative study. Lupus. 2010 Dec;19(14):1640-7. doi: 10.1177/0961203310378668.
8. Haghighi AB, Haza SG. Neuropsychiatric manifestations of systemic lupus erythematosus: Iranian experience. Annals of Indian Academy of Neurology. 2010 Apr;13:108-11. doi: 10.4103/0972-2327.64633.
9. Maneeton B, Maneeton N, Louthrenoo W. Prevalence and predictors of depression in patients with systemic lupus erythematosus: a cross-sectional study. Neuropsychiatric Disease and Treatment. 2013;9:799-804. doi: 10.2147/NDT.S44248.
10. Zhang L, Fu T, Yin R, Zhang Q, Shen B. Prevalence of depression and anxiety in systemic lupus erythematosus: A systemic review and meta-analysis. BioMed Central Psychiatry. 2017 Feb;17(1):70. doi: 10.1186/s12888-017-1234-1.
11. Shen B, Tan W, Feng G, He Y, Liu J, Chen W, Huang X, Da Z, Xu X, Liu H, Gu Z. The correlations of disease activity, socioeconomic status, quality of life, and depression/anxiety in Chinese patients with systemic lupus erythematosus. Clinical & Developmental Immunology. 2013; 2013:270878. doi: 10.1155/2013/270878.
12. Figueiredo-Braga M, Cornaby C, Bernardes M, Figueiredo M, Mesquita CDS, Costa L, Poople BD. Correlation between physical markers and psychiatric health in a Portuguese systemic lupus erythematosus cohort: the role of suffering in chronic autoimmune disease. Public Library of Science ONE. 2018 Apr;13(4):e0195579. doi: 10.1371/journal.pone.0195579.
13. Mikdashi J, Nived O. Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research. Arthritis Research & Therapy. 2015 Jul 20;17(1):183. doi: 10.1186/s13075-015-0702-6.
14. Alsowaida N, Alrasheed M, Mayet A, Alsuwaida A, Omair MA. Medication adherence, depression and disease activity among patients with systemic lupus erythematosus. Lupus. 2018 Feb;27(2):327-32. doi: 10.1177/0961203317725585.
15. Shen B, Feng G, Tang W, Huang X, Yan H, He Y, Chen W, Da Z, Liu H, Gu Z. The quality of life in Chinese patients with systemic lupus erythematosus with disease activity and psychiatric disorders: a path analysis. Clinical & Experimental Rheumatology. 2014 Jan-Feb ;32(1):101 -7.
16. Nicassio PM, Carr FN, Moldvan I. An overview of psychological functioning in systemic lupus erythematosus. International Journal of Clinical Rheumatology. 2011;6(5):569-81. doi: 10.2217/IJR.11.45.
17. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The committee on prognosis studies in SLE. Arthritis and Rheumatism. 1992 Jun;35(6):630-40. doi: 10.1002/art.1780350606.
18. Curtis JR, Yang S, Chen L, Pope JE, Keystone EC, Haraoui B, Boire G, Thorne JC, Tin D, Hitchon CA, Bingham 3rd CO, Bykerk VP. Determining the minimally important difference in the clinical disease activity index for improvement and worsening in early rheumatoid arthritis. Arthritis Care & Research. 2015;67(10):1345-53. doi: 10.1002/acr.22606.
19. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinaviaca. 1983 Jun;67(6):361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x.
20. McElbone K, Abbott J, Shelmerdine J, Bruce IN, Ahmad Y, Gordon C, Peers K, Isenberg D, Ferenkeh-Koroma A, Griffiths B, Akil M, Maddison P, Teh LS. Development and validation of a disease-specific health-related quality of life measure, the LupusQol, for adults with systemic lupus erythematosus. Arthritis and Rheumatism. 2007 Aug 15;57(6):972-9. doi: 10.1002/art.22881.
21. Yilmaz-Oner S, Oner C, Dogukan FM, Moses TF, Demir K, Tekayev N, Atagunduz P, Tuglular S, Direskeneli H. Health-related quality of life assessed by LupusQoL questionnaire and SE-36 in Turkish patients with systemic lupus erythematosus. Clinical Rheumatology. 2016 Mar;35(3):617-22. doi: 10.1007/s10067-015-2930-1
22. Pamuk ON, Onat AM, Donmez S, Mengüs C, Kisacik B. Validity and reliability of the lupus QoL index in Turkish systemic lupus erythematosus patients. Lupus. 2015 Jul;24(8):816-21. doi: 10.1177/0961203314565412.
23. Figueiredo-Braga M, Cornaby C, Cortez A, Pharm M, Bernardes M, Terroso G, Figueiredo M, Santos Mesquita CD, Costa L, Poole BD. Depression and anxiety in systemic lupus erythematosus: the crosstalk between immunological, clinical, and psychosocial factors. Medicine (Baltimore). 2018 Jul;97(28):e11376. doi: 10.1097/MD.0000000000011376
24. Mak A, Tang CSK, Chan MF, Cheak AAC, Ho RCM. Damage accrual, cumulative glucocorticoid dose and depression predict anxiety in patients with systemic lupus erythematosus. Clinical Rheumatology. 2011 Jun;30(6):795-803. doi: 10.1007/s10067-010-1651-8
25. Yang YO, Kim M, Park KY. Meta-analysis of social psychological factors related to quality of life in stroke patients. Journal of Korean Academy of Community Health Nursing. 2018;29(4):510-9. doi: 10.12799/jkachn.2018.29.4.510
26. Olesińska M, Saletra A. Quality of life in systemic lupus erythematosus and its measurement. Reumatologia. 2018;56(1):45--54. doi: 10.5114/reum.2018.74750.
27. Chaigne B, Chizzolini C, Perneger T, Trendelenburg M, Huynh-Do U, Dayer E, Stoll T, von Kempis J, Ribi C. Impact of disease activity on health-related quality of life in systemic lupus erythematosus-a cross-sectional analysis of the Swiss systemic lupus erythematosus cohort study (SSCS). BioMed Central Immunology. 2017 Mar;18(1):17. doi: 10.1186/s12865-017-0200-5.
28. Yim HW, Jeong H, Jung YE, Wang HR, Kim SY. Management of depression and suicide. Journal of the Korean Medical Association. 2011 Mar;54(3):275-83. doi: 10.5124/jkma.2011.54.3.275
29. Mazzoni D, Cicognani D. Social support and health in patients with systemic lupus erythematosus: a literature review. Lupus. 2011 Oct;20(11):1117-25. doi: 10.1177/0961203311412994.
2. Bae EH, Lim SY, Han KD, Jung JH, Choi HS, Kim HY, Kim CS, Ma SK, Kim SW. Trend of prevalence and incidence of systemic lupus erythematosus in South Korea, 2005 to 2015: a nationwide population-based study. Korean Journal of Internal Medicine. 2020 May;35(3):652-61. doi: 10.3904/kjim.2018.303.
3. Larsen. JL, Hall EOC, Jacobsen S, Birkelund R. The existential experience of everyday life with systemic lupus erythematosus. Journal of Advanced Nursing.2018;74:1170-9. doi:10.1111/jan.13525
4. Hyphantis T, Palieraki K, Voulgari PV, Tsifetaki N, Drosos AA. Coping with health-stressors and defence styles associated with health-related quality of life in patients with systemic lupus erythematosus. Lupus. 2011 Aug;20(9):893-903. doi: 10.1177/0961203311398264.
5. Schmeding A, Schneider M. Fatigue, health-related quality of life and other patient-reported outcomes in systemic lupus erythematosus. Best Practice & Research and Clinical Rheumatology. 2013 Jun;27(3):363-75. doi: 10.1016/j.berh.2013.07.009.
6. Etchegaray-Morales I, Meindez-Martinez S, Jimenez-Hernández C, Mendoza-Pinto C, Alonso-Garcia NE, Montiel-Jarquin A, Lopez-Colombo A, Garcia-Villaserior A, Cardiel MH, Garcia-Carrasco M. Factors associated with health-related quality of life in Mexican lupus patients using the lupusqol. Public Library of Science ONE. 2017 Jan;12(1):e0170209. doi: 10.1371/journal.pone.0170209.
7. McElhone K, Abbott J, Gray J, Williams A, Teh LS. Patient perspective of systemic lupus erythematosus in related to health-related quality of life concepts: A qualitative study. Lupus. 2010 Dec;19(14):1640-7. doi: 10.1177/0961203310378668.
8. Haghighi AB, Haza SG. Neuropsychiatric manifestations of systemic lupus erythematosus: Iranian experience. Annals of Indian Academy of Neurology. 2010 Apr;13:108-11. doi: 10.4103/0972-2327.64633.
9. Maneeton B, Maneeton N, Louthrenoo W. Prevalence and predictors of depression in patients with systemic lupus erythematosus: a cross-sectional study. Neuropsychiatric Disease and Treatment. 2013;9:799-804. doi: 10.2147/NDT.S44248.
10. Zhang L, Fu T, Yin R, Zhang Q, Shen B. Prevalence of depression and anxiety in systemic lupus erythematosus: A systemic review and meta-analysis. BioMed Central Psychiatry. 2017 Feb;17(1):70. doi: 10.1186/s12888-017-1234-1.
11. Shen B, Tan W, Feng G, He Y, Liu J, Chen W, Huang X, Da Z, Xu X, Liu H, Gu Z. The correlations of disease activity, socioeconomic status, quality of life, and depression/anxiety in Chinese patients with systemic lupus erythematosus. Clinical & Developmental Immunology. 2013; 2013:270878. doi: 10.1155/2013/270878.
12. Figueiredo-Braga M, Cornaby C, Bernardes M, Figueiredo M, Mesquita CDS, Costa L, Poople BD. Correlation between physical markers and psychiatric health in a Portuguese systemic lupus erythematosus cohort: the role of suffering in chronic autoimmune disease. Public Library of Science ONE. 2018 Apr;13(4):e0195579. doi: 10.1371/journal.pone.0195579.
13. Mikdashi J, Nived O. Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research. Arthritis Research & Therapy. 2015 Jul 20;17(1):183. doi: 10.1186/s13075-015-0702-6.
14. Alsowaida N, Alrasheed M, Mayet A, Alsuwaida A, Omair MA. Medication adherence, depression and disease activity among patients with systemic lupus erythematosus. Lupus. 2018 Feb;27(2):327-32. doi: 10.1177/0961203317725585.
15. Shen B, Feng G, Tang W, Huang X, Yan H, He Y, Chen W, Da Z, Liu H, Gu Z. The quality of life in Chinese patients with systemic lupus erythematosus with disease activity and psychiatric disorders: a path analysis. Clinical & Experimental Rheumatology. 2014 Jan-Feb ;32(1):101 -7.
16. Nicassio PM, Carr FN, Moldvan I. An overview of psychological functioning in systemic lupus erythematosus. International Journal of Clinical Rheumatology. 2011;6(5):569-81. doi: 10.2217/IJR.11.45.
17. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The committee on prognosis studies in SLE. Arthritis and Rheumatism. 1992 Jun;35(6):630-40. doi: 10.1002/art.1780350606.
18. Curtis JR, Yang S, Chen L, Pope JE, Keystone EC, Haraoui B, Boire G, Thorne JC, Tin D, Hitchon CA, Bingham 3rd CO, Bykerk VP. Determining the minimally important difference in the clinical disease activity index for improvement and worsening in early rheumatoid arthritis. Arthritis Care & Research. 2015;67(10):1345-53. doi: 10.1002/acr.22606.
19. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinaviaca. 1983 Jun;67(6):361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x.
20. McElbone K, Abbott J, Shelmerdine J, Bruce IN, Ahmad Y, Gordon C, Peers K, Isenberg D, Ferenkeh-Koroma A, Griffiths B, Akil M, Maddison P, Teh LS. Development and validation of a disease-specific health-related quality of life measure, the LupusQol, for adults with systemic lupus erythematosus. Arthritis and Rheumatism. 2007 Aug 15;57(6):972-9. doi: 10.1002/art.22881.
21. Yilmaz-Oner S, Oner C, Dogukan FM, Moses TF, Demir K, Tekayev N, Atagunduz P, Tuglular S, Direskeneli H. Health-related quality of life assessed by LupusQoL questionnaire and SE-36 in Turkish patients with systemic lupus erythematosus. Clinical Rheumatology. 2016 Mar;35(3):617-22. doi: 10.1007/s10067-015-2930-1
22. Pamuk ON, Onat AM, Donmez S, Mengüs C, Kisacik B. Validity and reliability of the lupus QoL index in Turkish systemic lupus erythematosus patients. Lupus. 2015 Jul;24(8):816-21. doi: 10.1177/0961203314565412.
23. Figueiredo-Braga M, Cornaby C, Cortez A, Pharm M, Bernardes M, Terroso G, Figueiredo M, Santos Mesquita CD, Costa L, Poole BD. Depression and anxiety in systemic lupus erythematosus: the crosstalk between immunological, clinical, and psychosocial factors. Medicine (Baltimore). 2018 Jul;97(28):e11376. doi: 10.1097/MD.0000000000011376
24. Mak A, Tang CSK, Chan MF, Cheak AAC, Ho RCM. Damage accrual, cumulative glucocorticoid dose and depression predict anxiety in patients with systemic lupus erythematosus. Clinical Rheumatology. 2011 Jun;30(6):795-803. doi: 10.1007/s10067-010-1651-8
25. Yang YO, Kim M, Park KY. Meta-analysis of social psychological factors related to quality of life in stroke patients. Journal of Korean Academy of Community Health Nursing. 2018;29(4):510-9. doi: 10.12799/jkachn.2018.29.4.510
26. Olesińska M, Saletra A. Quality of life in systemic lupus erythematosus and its measurement. Reumatologia. 2018;56(1):45--54. doi: 10.5114/reum.2018.74750.
27. Chaigne B, Chizzolini C, Perneger T, Trendelenburg M, Huynh-Do U, Dayer E, Stoll T, von Kempis J, Ribi C. Impact of disease activity on health-related quality of life in systemic lupus erythematosus-a cross-sectional analysis of the Swiss systemic lupus erythematosus cohort study (SSCS). BioMed Central Immunology. 2017 Mar;18(1):17. doi: 10.1186/s12865-017-0200-5.
28. Yim HW, Jeong H, Jung YE, Wang HR, Kim SY. Management of depression and suicide. Journal of the Korean Medical Association. 2011 Mar;54(3):275-83. doi: 10.5124/jkma.2011.54.3.275
29. Mazzoni D, Cicognani D. Social support and health in patients with systemic lupus erythematosus: a literature review. Lupus. 2011 Oct;20(11):1117-25. doi: 10.1177/0961203311412994.
| Files | ||
| Issue | Vol 8 No 3 (2021): Summer | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v8i3.5936 | |
| Keywords | ||
| lupus erythematosus; quality of life; anxiety; depression | ||
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How to Cite
1.
Cho O-H, Hwang K-H, Lim J. The influence of anxiety and depression on Korean lupus patients’ quality of life. NPT. 2021;8(3):216-225.
