Prevalence of depressive and anxiety disorders in systemic lupus erythematosus and their association with anti-ribosomal P antibodies

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2008-04, Vol.32 (3), p.695-700
• Main Authors: Nery, Fabiano G., Borba, Eduardo F., Viana, Vilma S.T., Hatch, John P., Soares, Jair C., Bonfá, Eloísa, Neto, Francisco Lotufo
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Anti-ribosomal P antibodies; Antibodies - blood; Anxiety disorders; Anxiety Disorders - epidemiology; Anxiety Disorders - etiology; Anxiety Disorders - immunology; Biological and medical sciences; Depression; Depressive disorder; Depressive Disorder - epidemiology; Depressive Disorder - etiology; Depressive Disorder - immunology; Enzyme-Linked Immunosorbent Assay; Female; Humans; Lupus erythematosus; Lupus Erythematosus, Systemic - complications; Medical sciences; Middle Aged; Mood disorders; Neuropharmacology; Pharmacology. Drug treatments; Prevalence; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Retrospective Studies; Ribosomal Proteins - immunology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Severity of Illness Index; systemic
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2007.11.014

To estimate the prevalence of psychiatric disorders in patients with systemic lupus erythematosus (SLE) and explore their association with anti-ribosomal P (anti-P) antibodies. Seventy-one consecutive female SLE patients without neurological manifestations were evaluated for psychiatric disorders using the Structured Clinical Interview for DSM-IV (SCID). Anti-P antibodies were measured by enzyme-linked immunosorbent assay (ELISA)/immunoblot analysis. The mean age of subjects was 34.8 years (SD: 10.1 years), and the mean duration of SLE was 9.8 years (SD: 6.5 years). The 30-day prevalences of psychiatric disorders were: mood disorders 26.8%, anxiety disorders 46.5%, adjustment disorders 8.4%, alcohol abuse 1.4%, and somatoform disorder 1.4%. The lifetime prevalences of psychiatric disorders were: mood disorders 69%, anxiety disorders 52.1%, alcohol abuse 1.4%, and somatoform disorder 1.4%. Subjects with and without psychiatric manifestations did not differ regarding SLE clinical and laboratorial parameters including presence or absence of anti-P antibodies (23.1% vs. 20%, respectively, p = 1.0), disease activity, as measured by the Systemic Lupus Erythematosus Disease activity Index (4.08 ± 5.7 vs. 4.95 ± 6.3 respectively, p = 0.60) and cumulated damage, as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (0.7 ± 2.3 vs. 0.3 ± 0.7 respectively, p = 0.33). Mood and anxiety disorders are the most frequently observed psychiatric disorders in female SLE patients without concomitant neurological manifestations. These mild/moderate forms of psychiatric disorders are not associated with anti-P antibodies in SLE patients. Our findings reinforce the importance of systematic psychiatric evaluation for these patients in order to provide adequate and comprehensive care.