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Anxiety and depression lower quality of life in majority of systemic lupus erythematosus patients

92.8% of patients with systemic lupus erythematosus (SLE) suffer anxiety and depression which significantly affects both their physical and emotional quality of life (QoL), according to the results of a new study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark. Logistic regression analysis revealed that depression was the most significant factor shown to affect QoL (p=0.015; OR=0.18; CI 95%:0.045-0.72).

In the study, 92.8% (52 of 56) of the patients who were diagnosed with SLE had an element of confirmed neuropsychiatric (NP) involvement (including anxiety, depression, mild cognitive deficits and major NP involvement). Several other conditions that may occur alongside SLE were also shown to influence aspects of QoL (as measured by a selection of health assessment tools), including:

Cutaneous (skin) conditions as Raynaud's phenomenon (identified in 37.5% of the patients)

Serositis (identified in 8.9% of the patients)

Hyperhomocysteinemia (a blood disorder that is a risk factor for coronary artery disease) (identified in 39.3% of the patients)

Antiphospholipid antibodies (a disorder of coagulation) (identified in 66.1% of the patients)

Dr Paola Tomietto of the University of Trieste, Italy, who conducted the study, said: "People with SLE experience a range of both psychological and physical symptoms which can negatively impact their quality of life. This study shows that the psychological impact of SLE on quality of life includes elements of anxiety and depression. Thus, clinicians should try to identify and address the presence of mood disorders in their SLE patients in order to improve both their emotional quality of life but and, ultimately, their physical functioning."

56 consecutive SLE patients undertook the Medical Outcome Survey Short Form 36 (SF-36), to assess health-related quality of life, the Hospital Anxiety and Depression Scale and a neuropsychological battery for testing cognitive deficits. Neuropsychiatric and extra-cerebral involvement, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) damage indexes, antiphospholipid antibodies and hyperhomocysteinemia were recorded for all the patients. Data were analysed through the Spearman correlation coefficient and a logistic regression analysis.

SLICC-DI was correlated with the physical activity (PA) subscale of the SF-36 (r=-0.44; p=0.001) and with the physical component summary (PCS) (r=-0.267; p=0.047); it was related also to the number of NP events (r=0.35; p=0.007). SLEDAI did not correlate with any of the subscale of SF-36. The total summary score, the PCS and the mental component summary (MCS) scores of the SF-36 were all inversely correlated with the number of NP events (for all r=-0,5, p

SLE is a complex autoimmune disease characterised by chronic inflammation and damage to body tissues, which occurs as a result of the production of abnormal antibodies that target and cause damage to cells of the patient's body, including immune cells. SLE has the potential to affect a variety of areas of the body, including the heart, lungs, kidneys, joints, and/or nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remission. Lupus can occur at any age but is most common in women, particularly of non-European descent.

For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress press office on:
Rory Berrie: Onsite tel: +44 (0) 7894 386 425
Camilla Dormer: Onsite tel: +44 (0) 7876 190 439
Abstract number: FRI0292
The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations.

In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems.

The aims of EULAR are to stimulate, promote, and support the research, prevention, treatment and rehabilitation of rheumatic diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with rheumatic diseases.

In 2009, The EULAR Executive Committee launched the EULAR Orphan Disease Programme (ODP) which aims to provide funding to research programmes focused on furthering understanding of the disease mechanisms behind systemic sclerosis. Please see for further information.

Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer.

As new treatments emerge and cellular mechanisms are discovered, EULAR 2009 is set to be the biggest rheumatology event in Europe with over 13,500 scientists, physicians, allied health professionals, and related audiences in attendance from over 100 countries. Over the course of the congress, more than 300 oral and 1700 poster abstract presentations will be featured, with 780 invited speaker lectures taking place in more than 150 sessions.

Rory Berrie | EurekAlert!
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