Association of clinical characteristics, disease activity and health-related quality of life in SLE patients with major depressive disorder.

OBJECTIVE To determine the contributing factors associated with MDD in SLE patients and examine the association between disease-specific health-related quality of life (LupusQoL) domains and MDD. METHODS Depression was assessed by the patient health questionnaire (PHQ)-9, and scores above ≥10 are indicating MDD. Demographic data, LupusQoL domains, clinical and other features of the SLE patients were described and compared between MDD (PHQ-9 ≥ 10) and non-MDD (PHQ-9 < 10) groups using Chi-square tests for categorical variables and Wilcoxon rank sum tests for non-normal continuous variables. The risk of MDD was evaluated for the patient and physician-reported features individually using log-binomial models to estimate relative risks and 95% confidence limits. RESULTS Eighty-eight patients with SLE met eligibility criteria with a mean age of 48.6 (19-80), were mostly female (80%), and mean disease duration of 13.2 years. Compared to the non-MDD group, patients with MDD (n = 32, 36%) were more likely to have the following SLE manifestations: mucocutaneous, vascular, ocular, pulmonary and musculoskeletal involvement. Self-rated health described as poor/fair was markedly associated with MDD (P < 0.001, RR = 0.48). Based on relative risks, higher pain VAS, patient and physician global assessment scores were also linked to MDD. The LupusQoL domains' scores were notably lower in the MDD patients, with a statistically significant reduction in all LupusQoL domains. CONCLUSION Predictors of MDD in SLE patients include higher scores in pain and global assessment, poor or fair self-reported health, and specific organ involvement. These findings may help clinicians to recognize and manage MDD promptly.