Persistent depression in systemic lupus erythematosus patients despite therapy: Study

USA: A new study conducted by Sara R. Kellahan and team shows that over a four-year period, the majority of patients (61.2 percent) had Center for Epidemiologic Studies Depression Scale, Revised (CESD-R) values consistent with persistent depressed affect or severe depression. The findings of this data were published in Arthritis Care & Research.

In individuals with systemic lupus erythematosus (SLE), depression is a common (24-30%) and important comorbidity. Researchers used the longitudinal SLE cohort at the Washington University Lupus Clinic in this study to answer the following questions: 1) What is the longitudinal course of depressive affect among outpatients with SLE? 2) What is the link between SLE disease activity and low mood over time?

Longitudinal data from individuals with SLE defined by the ACR or the Systemic Lupus International Collaborating Clinics (SLICC) were evaluated for this study. The Center for Epidemiologic Studies Depression Scale, Revised (CESD-R) was used to assess depressive symptoms at each visit, while the SLEDAI2K Responder Index-50 was used to assess SLE disease activity (S2K RI-50). For the study, we employed group-based trajectory modeling (GBTM) and linear mixed models.

The results of this study stated as follow:

1. The sample (n=144) consisted of 56.3% black people and 38.9% white people.

2. GBTM identified five unique groups of individuals who showed persistent depressive tendencies over time. Groups 4 (n=44, 30.6%) and 5 (n=44, 30.6%) had CESD-R values that were indicative of depression.

3. In Group 5 (n=32, 72.7%), Black patients were significantly more prevalent (n=32, 72.7%).

4. In multivariate analysis, researchers discovered a link between SLEDAI disease activity and depression ratings, but not in GBTM or univariate analysis.

In conclusion, while disease activity in SLE patients fluctuates over time, depression ratings did not show any sign of these changes. Furthermore, the large proportion of Black individuals among those with the worse depression ratings reveals a significant gap.

Reference:

Kellahan, S.R., Huang, X., Lew, D., Xian, H., Eisen, S. and Kim, A.H.J. (2022), Depressed Symptomatology Persists Over Time in Systemic Lupus Erythematosus Patients. Arthritis Care Res. Accepted Author Manuscript. https://doi.org/10.1002/acr.24833