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Shantz E, Elliott SJ, Sperling C, Buhler K, Costenbader KH, Choi MY. Towards an understanding of the biopsychosocial determinants of CVD in SLE: a scoping review. Lupus Sci Med 2024; 11:e001155. [PMID: 39053931 DOI: 10.1136/lupus-2024-001155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is a chronic autoimmune condition with significant physical, mental, psychosocial and economic impacts. A main driver of SLE morbidity and mortality is cardiovascular disease (CVD). Both SLE and CVD exhibit disparities related to gender, race and other social dimensions linked with biological outcomes and health trajectories. However, the biospsychosocial dimensions of CVD in SLE populations remain poorly understood. The objective of this study was to systematically investigate the existing literature around known social factors influencing the development of CVD in SLE. METHODS A scoping review protocol was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping reviews guidelines. The search strategy encompassed three main concepts: SLE, CVD and social factors. Four databases were searched (PubMed, SCOPUS, PsychINFO and CINAHL). 682 studies were identified for screening. Articles were screened in two phases (title/abstract and full text) to determine whether they fulfilled the selection criteria. RESULTS Nine studies were included after screening. All were conducted in the USA between 2009 and 2017. Six studies (67%) were cross-sectional and three (33%) were longitudinal. Most employed SLE cohorts (n=7, 78%) and two drew from healthcare databases (n=2; 22%). We identified five main themes encompassing social factors: socioeconomic status and education (n=5; 56%), race and/or ethnicity (n=7; 78%), mental health (n=2; 22%), gender (n=3; 33%) and healthcare quality and/or insurance (n=2; 22%). Overall, low income, fewer years of education, black race and/or ethnicity, depression, male gender, lack of insurance and healthcare fragmentation were all associated with CVD risk factors and outcomes in SLE. CONCLUSIONS While several social factors contribute to CVD in SLE populations, considerable gaps remain as many social determinants remain un(der)explored. There is rich opportunity to integrate social theory, advance conceptualisations of race and/or ethnicity and gender, expand investigations of mental health and explore novel geographical contexts. In healthcare policy and practice, identified social factors should be considered for SLE populations during decision-making and treatment, and education resources should be targeted for these groups.
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Affiliation(s)
- Emily Shantz
- Geography & Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan J Elliott
- Geography & Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Katherine Buhler
- Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Karen H Costenbader
- Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - May Y Choi
- Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Simbar M, Ghasemi V, Taherian R, Kalhor M, Mohammadian F, Kiani Z. Prevalence of anxiety symptoms in infertile men: a systematic review and meta-analysis. BMC Public Health 2024; 24:1805. [PMID: 38971742 PMCID: PMC11227185 DOI: 10.1186/s12889-024-19299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Infertility in men causes problems in various aspects of their lives, including personal, family and social life. One of the most important of these problems is anxiety. Anxiety in infertile men can affect their health, quality of life, and response to treatment, highlighting the significance of anxiety in these men. Thus, this systematic review and meta-analysis was conducted to investigate the prevalence of anxiety symptoms in infertile men. METHODS To conduct this review study, two researchers independently searched international databases such as PubMed, Cochrane Library, Web of sciences, Scopus, PsyINFO, and the Google scholar search engine in English without considering any time limit until January 2, 2024. Keywords such as "anxiety," "infertility," "prevalence," and "epidemiology" were used, taking into account the specific search method of each database. Using the Newcastle-Ottawa Scale (NOS), the quality of the articles was evaluated by two researchers independently. RESULTS In the systematic part of the study, 27 studies were included, and given the variety of measurement tools (8 different tools) used to investigate anxiety symptoms in infertile men, 24 studies were analyzed in five subgroups of tools. The pooled prevalence of anxiety symptoms in infertile men was 21.37% (95% CI: 15.73-27.02). The lowest and highest prevalence of anxiety in infertile men were related to the Beck anxiety inventory (BAI) and Depression Anxiety Stress Scales (DASS), accounting for 7.08% (95% CI: 3.27-10.90) and 34.90% (95%CI: 28.90-40.90) values respectively. This prevalence was 19.80% (95%CI: 9.01-30.59) for the Hospital Anxiety and Depression Scale (HADS), 30.06% (95%CI: 18.59-41.52) for the Spielberger Trait Anxiety Inventory (STAI-T), and 18.52% (95%CI: 7.76-29.29) for the Self-Rating Anxiety Scale (SAS). CONCLUSION The results of this systematic review and meta-analysis indicated that the prevalence of anxiety symptoms in infertile men requires special attention to healthcare planning. The healthcare system of different countries should evaluate the symptoms of anxiety in infertile men and take appropriate measures to reduce them according to the culture of the countries. It is recommended that all infertile couples be assessed for anxiety symptoms using a standardized tool during their initial evaluation.
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Affiliation(s)
- Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vida Ghasemi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Reza Taherian
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehri Kalhor
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fateme Mohammadian
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Goldschen L, Peng CS, Mufson MJ, Feldman CH, Case SM, Costenbader KH, Amonoo HL. Barriers, Facilitators, and Preferences for Mental Health Services Among Patients With Systemic Lupus Erythematosus: A Qualitative Study. Arthritis Care Res (Hoboken) 2024; 76:914-925. [PMID: 38433607 PMCID: PMC11209808 DOI: 10.1002/acr.25321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 02/09/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Although patients with systemic lupus erythematosus (SLE) experience high levels of depression and anxiety disorders, evidence concerning patient perceptions of facilitators and barriers to effective uptake of mental health services (eg, referral to therapists and psychiatrists, psychoeducational interventions, or support groups) is limited. METHODS We conducted semistructured qualitative interviews with 15 adults with SLE to explore patient experiences and perceptions of mental health services to identify facilitators and barriers to accessing mental health care among patients with SLE. Qualitative interviews were conducted via telephone and audio recorded for transcription and directed content analysis using NVivo software by two coders. RESULTS The median age of the 15 participants was 48 years, 87% were female, 33% identified as Black or African American, and 33% identified as Hispanic or Latino. Qualitative themes were organized into three domains: barriers, facilitators, and preferences for mental health services. Barriers to the use of mental health services include mental health stigma, sociodemographic factors, lack of autonomy, and time commitment. Facilitators to the use of mental health services included strong relationships with their rheumatologists and mental health care clinician experience with patients with SLE. Preferences for mental health services included education-based formats, mental health providers who work with patients with SLE, peer group formats, demographically and disease-matched psychological resources, and an emphasis on non-disease-related activities. CONCLUSION In the setting of persistent unmet psychosocial needs of patients living with SLE, data from this qualitative study will inform the development and refinement of mental health interventions that bolster psychological wellbeing in the SLE population.
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Affiliation(s)
- Lauren Goldschen
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Cynthia S. Peng
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Michael J. Mufson
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Candace H. Feldman
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Siobhan M. Case
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Karen H. Costenbader
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Hermioni L. Amonoo
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
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Katz PP, Barber CEH, Duarte-García A, Garg S, Machua W, Rodgers W, Santiago-Casas Y, Suter L, Bartels CM, Yazdany J. Development of the American College of Rheumatology Patient-Reported Outcome Quality Measures for Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2024; 76:777-787. [PMID: 38225171 PMCID: PMC11132939 DOI: 10.1002/acr.25301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/27/2023] [Accepted: 01/11/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE As part of a Centers for Disease Control and Prevention-funded American College of Rheumatology (ACR) initiative, we sought to develop quality measures related to Patient Reported Outcome Measure (PROM) use for systemic lupus erythematosus (SLE) clinical care. METHODS An expert workgroup composed of physician, patient, and researcher representatives convened to identify patient-reported outcome (PRO) domains of greatest importance to people with SLE. A patient advisory panel separately ranked domains. PROMs assessing priority domains were identified through structured literature review, and detailed psychometric reviews were conducted for each PROM. In a Delphi process, the expert workgroup rated PROMs on content validity, psychometric quality, feasibility of implementation, and importance for guiding patient self-management. The patient advisory panel reviewed PROMs in parallel and contributed to the final recommendations. RESULTS Among relevant PRO domains, the workgroup and patient partners ranked depression, physical function, pain, cognition, and fatigue as high-priority domains. The workgroup recommended at least once yearly measurement for (1) assessment of depression using the Patient Health Questionnaire or Patient Reported Outcomes Measurement Information System (PROMIS) depression scales; (2) assessment of physical function using PROMIS physical function scales or the Multi-Dimensional Health Assessment Questionnaire; and (3) optional assessments of fatigue and cognition. Pain scales evaluated were not found to be sufficiently superior to what is already assessed in most SLE clinic visits. CONCLUSION Expert workgroup members and patient partners recommend that clinicians assess depression and physical function at least once yearly in all people with SLE. Additional PROMs addressing cognition and fatigue can also be assessed. Next steps are to incorporate PROM-based quality measures into the ACR The Rheumatology Informatics System for Effectiveness registry.
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Affiliation(s)
| | | | | | - Shivani Garg
- University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Wendy Rodgers
- Lupus Foundation Care and Support Services, Los Angeles, California
| | | | - Lisa Suter
- Yale School of Medicine, New Haven, Connecticut, and Veterans Administration Hospital, West Haven, Connecticut
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Zhang L, Zhu W, Ye J. Psychological status is associated with the perceived illness stigma in Chinese systemic lupus erythematosus patients. PSYCHOL HEALTH MED 2024; 29:1035-1043. [PMID: 37840241 DOI: 10.1080/13548506.2023.2270511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
Systemic lupus erythematosus (SLE) might affect all aspects of life including perceived stigma, but research on perceived stigma is still in its infancy among SLE patients. The objective of this study was to assess the relationships among socioeconomic status, clinical parameters, disease activity, quality of life, depression, and the perceived stigma in Chinese patients with SLE. A total of 133 SLE patients (mean age: 39.36 ± 12.91 years) were included in this cross-sectional study. All data were collected consecutively by face-to-face questionnaires from January 2021 to January 2022. SLE patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) for disease activity, the patient health questionnaire-9 (PHQ-9) for depression, the Perceived Devaluation Discrimination (PDD) Scale for the perceived stigma, and the Short Form 12 health survey (SF-12) for quality of life. Independent sample t-test, Spearman or Pearson correlations analysis, and the multivariable linear regression model were used to analyze these data. The mean PDD scale score in the SLE patients was 2.79 ± 0.33, which were statistically significant compared with the midpoint (2.50 ± 0.38) of the scale (P < 0.05). The perceived stigma was significantly correlated with income, pain, disease activity, depression, and quality of life. The SF-12 mental composite summaries (MCS) score and depression were the important predictors of the perceived stigma by the multivariable linear regression. This study demonstrates that psychological status is significantly associated with the perceived illness stigma in Chinese SLE patients; dealing with this stigma may be important in promoting optimal coping for these patients.
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Affiliation(s)
- Lijuan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Zhu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junna Ye
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kiani Z, Simbar M, Rashidi F, Zayeri F, Banaderakhsh H. The quality of life of men experiencing infertility: a systematic review. BMC Public Health 2024; 24:1236. [PMID: 38705989 PMCID: PMC11070083 DOI: 10.1186/s12889-024-18758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 05/02/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Men experiencing infertility encounter numerous problems at the individual, family, and social levels as well as quality of life (QOL). This study was designed to investigate the QOL of men experiencing infertility through a systematic review. MATERIALS AND METHODS This systematic review was conducted without any time limitation (Retrieval date: July 1, 2023) in international databases such as Scopus, Web of Science, PubMed, and Google Scholar. The search was performed by two reviewers separately using keywords such as QOL, infertility, and men. Studies were selected based on inclusion and exclusion criteria. The quality of the articles were evaluated based on the Newcastle-Ottawa Scale. In the initial search, 308 studies were reviewed, and after removing duplicates and checking the title and abstract, the full text of 87 studies were evaluated. RESULTS Finally, 24 studies were included in the final review based on the research objectives. Based on the results, men's QOL scores in different studies varied from 55.15 ± 13.52 to 91.45 ± 13.66%. Of the total reviewed articles, the lowest and highest scores were related to mental health problems and physical dimensions, respectively. CONCLUSION The reported findings vary across various studies conducted in different countries. Analysis of the factors affecting these differences is necessary, and it is recommended to design a standard tool for assessing the quality of life of infertile men. Given the importance of the QOL in men experiencing infertility, it is crucial to consider it in the health system. Moreover, a plan should be designed, implemented and evaluated according to each country's contex to improve the quality of life of infertile men.
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Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farzaneh Rashidi
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Farid Zayeri
- Proteomics Research Center, Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoon Banaderakhsh
- Department of Anesthesia and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang K, Hou X, Lu H, Han N, Xie M, Xi A, Xu Z. Ectopic CD4 + T cells in choroid plexus mediate neuropsychiatric lupus symptoms in mice via interferon-γ induced microglia activation. J Autoimmun 2024; 145:103199. [PMID: 38452512 DOI: 10.1016/j.jaut.2024.103199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Neuropsychiatric systemic lupus erythematosus (NPSLE) is a disabling and potentially life-threatening complication of SLE. This study aims to investigate whether ectopic CD4+ T cells in the choroid plexus mediate NPSLE in mice. Intracerebroventricular (ICV) injection of anti-CD4 antibody effectively depleted CP-resident CD4+ T cells and alleviated NPSLE-like symptoms in MRL/lpr mice. Following ICV injection, the majority of isolated lupus CD4+ T cells from donor MRL/lpr mice predominantly stayed in the CP for at least 28 days in recipient C57BL/6 mice, while nearly all isolated CD4+ T cells from MRL/MpJ mice disappeared within 7 days. ICV injection of lupus CD4+ T cells resulted in NPSLE-like symptoms, including impaired behavioral performances, increased microglial activation, and abnormal microstructure changes. Flow cytometry analysis revealed that the majority of isolated lupus CD4+ T cells were positive for IFN-γ. Neutralizing intracerebral IFN-γ alleviated NPSLE-like symptoms in MRL/lpr mice. Moreover, ICV injection of anti-IFN-γ antibody or microglial depletion by PLX3397 benefited most NPSLE-like symptoms in lupus CD4+ T-treated mice, while ICV injection of IFN-γ mimicked most NPSLE-like symptoms. In conclusion, CP-resident lupus CD4+ T cells contribute to NPSLE-like symptoms in mice via Interferon-γ induced microglia activation. Depleting CP-resident lupus CD4+ T cells, interferon-γ, or activated microglia may be potential therapeutic targets for NPSLE.
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Affiliation(s)
- Keer Wang
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China
| | - Xiaoxiao Hou
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China
| | - Haimei Lu
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China
| | - Ning Han
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China
| | - Meijuan Xie
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China; Ji'an Hospital of Traditional Chinese Medicine, Jiangxi, China
| | - Anran Xi
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China
| | - Zhenghao Xu
- Research Institute of Chinese Medical Clinical Foundation and Immunology, College of Basic Medical Science & Wenzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Zhejiang, China.
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Ngandu Ntumba MH, Makan K, Musenge E, Tikly M. Comorbidities in Privately Insured South Africans With Systemic Lupus Erythematosus. Cureus 2024; 16:e55470. [PMID: 38571865 PMCID: PMC10988769 DOI: 10.7759/cureus.55470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Comorbidities in systemic lupus erythematosus (SLE) impact negatively on health-related quality of life (HRQoL) and life expectancy. We investigated the frequency and spectrum of comorbidities in privately insured South Africans with SLE. Methods The data of SLE patients based on International Classification of Diseases, Tenth Revision (ICD-10) codes and insured with Discovery Health Medical Scheme (DHMS), South Africa, aged ≥16 years at diagnosis and with ≥6 months of follow-up were reviewed. Demographics, comorbidities listed in the Charlson comorbidity index (CCI), other common comorbidities, intercurrent illnesses, and drug therapy were documented. Results Of the 520 patients coded as SLE, 207 met the inclusion criteria. Most were females (90.8%), with a median (interquartile range {IQR}) age and follow-up duration of 39 (30.3-53.0) and 6.1 (3.7-8.1) years, respectively. All patients had at least one comorbidity; the most frequent CCI comorbidities were pulmonary disease (30.9%), congestive heart failure (CHF, 15%), and renal disease (14.0%). Other common comorbidities were hypertension (53.1%) and mood and anxiety disorders (46.9%). Urinary tract infections (UTIs, 37.7%) and pneumonia (33.8%) were common intercurrent illnesses. The independent predictors of CHF were renal disease (odds ratio {OR}=855), dyslipidemia (OR=15.3), and male gender (OR=43.0); the independent predictors of hypertension were age at diagnosis (OR=1.03), type 2 diabetes (OR=4.45), and renal disease (OR=4.34); and the independent predictors of mood and anxiety disorders were female gender (OR=3.98), stroke (OR=3.18), UTI (OR=2.39), and chloroquine use (OR=1.94). Conclusion In this study of privately insured South Africans with SLE, comorbidities were common, and all patients had at least one comorbidity. Hypertension, infections, and mood and anxiety disorders were the leading comorbidities overall, and pulmonary disease was the most common CCI comorbidity. There is an obvious need to formally study the burden of mental health disorders in South African SLE patients.
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Affiliation(s)
- Mbombo Henriette Ngandu Ntumba
- Department of Internal Medicine, School of Clinical Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, Johannesburg, ZAF
| | - Kavita Makan
- Division of Rheumatology, Department of Internal Medicine, School of Clinical Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, Johannesburg, ZAF
| | - Eustasius Musenge
- School of Public Health, University of the Witwatersrand, Johannesburg, Johannesburg, ZAF
| | - Mohammed Tikly
- Division of Rheumatology, Department of Internal Medicine, School of Clinical Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, Johannesburg, ZAF
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Xue H, Liu S, Zeng L, Fan W. Causal effect of systemic lupus erythematosus on psychiatric disorders: A two-sample Mendelian randomization study. J Affect Disord 2024; 347:422-428. [PMID: 38008292 DOI: 10.1016/j.jad.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/19/2023] [Accepted: 11/09/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND This study aims to investigate the association between systemic lupus erythematosus (SLE) and the risk of seven psychiatric disorders through the application of Mendelian randomization (MR) analysis due to previous observational studies that have suggested a potential link between SLE and psychiatric disorders. METHODS We collected genetic instruments for SLE from a genome-wide association study (GWAS) involving 23,210 individuals. Seven psychiatric traits were enrolled from the recent largest GWAS, including major depression disorder (MDD), generalized anxiety disorder (GAD), schizophrenia (SCZ), bipolar disorder (BID), autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), and insomnia. Summary statistics for psychiatric disorders were obtained from different GWAS meta-analysis studies. The inverse variance weighted (IVW) method was used as the main MR analysis. RESULTS The IVW method indicated that SLE is associated with a higher risk of GAD (OR = 1.072, 95 % CI [1.017-1.129], P = 0.008) and SCZ (OR = 3.242, 95 % CI [1.578-6.660], P = 0.007). However, no evidence was found for the causal associations between SLE and other psychiatric disorders. Further analyses found no evidence of pleiotropy and heterogeneity. CONCLUSIONS This two-sample MR analysis provides evidence that genetically predicted SLE may increase the risk of GAD and SCZ in a European population. Future studies are needed to elucidate and investigate the mechanisms underlying these causal relationships. Considering the existence of racial genomic heterogeneity, our findings must be viewed with caution.
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Affiliation(s)
- Hua Xue
- Department of Neurology, Sichuan Taikang Hospital, Chengdu, Sichuan, China.
| | - Shuangjuan Liu
- Department of Neurology, Qionglai People's Hospital, Chengdu, Sichuan, China
| | - Li Zeng
- Department of Respiratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
| | - Wenhui Fan
- Department of Neurology, Sichuan Taikang Hospital, Chengdu, Sichuan, China.
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Kassim FM, Wordefo DK, Berhanu M, Megersa SW, Tessema SA. Psychiatric manifestations of systemic lupus erythematosus: A brief review with two case-reports. SAGE Open Med Case Rep 2024; 12:2050313X241229010. [PMID: 38313038 PMCID: PMC10838031 DOI: 10.1177/2050313x241229010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Neuropsychiatric systemic lupus erythematosus is a severe neurological and psychiatric manifestation following systemic lupus erythematosus. Neuropsychiatric systemic lupus erythematosus is a global concern with limited data on its impact on quality of life in Africa. Furthermore, there is a lack of published research on neuropsychiatric systemic lupus erythematosus in Ethiopia. In this article, we present two case reports of Ethiopian patients with systemic lupus erythematosus and neuropsychiatric systemic lupus erythematosus, highlighting the challenges of diagnosing neuropsychiatric systemic lupus erythematosus worldwide. Although the patients were treated with alternative pharmacological agents based on available medications, interdisciplinary collaboration between psychologists, psychiatrists, neurologists, and internists is necessary to decrease the burden of systemic lupus erythematosus patients with neuropsychiatric manifestations. Overall, symptomatic therapy for neuropsychiatric systemic lupus erythematosus in developing countries is a good approach until future evidence-based pharmacotherapy is developed.
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Affiliation(s)
- Faiz Mohammed Kassim
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Dureti Kassim Wordefo
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mahlet Berhanu
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Surafel Worku Megersa
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Nicoloro-SantaBarbara J, Majd M, Burdick KE, Dixon V, Giannetti MP. Cognitive Impairment and Depression in Mastocytosis: A Synthesis of the Literature. Curr Allergy Asthma Rep 2024; 24:53-62. [PMID: 38294589 DOI: 10.1007/s11882-024-01127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE OF REVIEW Symptoms of depression and cognitive dysfunction are commonly reported in mastocytosis. The aims of this review paper are to summarize the current literature on cognitive dysfunction and depressive symptoms, elucidate some of the mechanistic pathways underlying depressive symptoms in mastocytosis, identify gaps in the literature, and offer guidance for future research in this area. RECENT FINDINGS The study of cognition and depression in mastocytosis is in its infancy and the methodological flaws of the current literature limit interpretability. There is preliminary evidence that some individuals with mastocytosis might experience mild deficits in memory. On average, depression symptom scores fell within the mild to moderate or sub-syndromal range. Regrettably, only one study utilized a standardized diagnostic instrument to assess major depressive disorder. The authors' tendency to inaccurately equate depressive symptoms with a diagnosis of major depressive disorder presents a notable issue. The prevalence of cognitive deficits and depression appears to be similar to other chronic illnesses. Future work needs to better characterize cognition and characterize "depression" in this population.
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Affiliation(s)
- Jennifer Nicoloro-SantaBarbara
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Marzieh Majd
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Victoria Dixon
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Matthew P Giannetti
- Harvard Medical School, Boston, MA, USA
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, MA, USA
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Di Benedetto MG, Landi P, Mencacci C, Cattaneo A. Depression in Women: Potential Biological and Sociocultural Factors Driving the Sex Effect. Neuropsychobiology 2024; 83:2-16. [PMID: 38272005 PMCID: PMC10871691 DOI: 10.1159/000531588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/24/2023] [Indexed: 01/27/2024]
Abstract
Important sex-related differences have been observed in the onset, prevalence, and clinical phenotype of depression, based on several epidemiological studies. Social, behavioural, and educational factors have a great role in underlying this bias; however, also several biological factors are extensively involved. Indeed, sexually dimorphic biological systems might represent the underlying ground for these disparities, including cerebral structures and neural correlates, reproductive hormones, stress response pathways, the immune system and inflammatory reaction, metabolism, and fat distribution. Furthermore, in this perspective, it is also important to consider and focus the attention on specific ages and life stages of individuals: indeed, women experience during their life specific periods of reproductive transitional phases, which are not found in men, that represent windows of particular psychological vulnerability. In addition to these, other biologically related risk factors, including the occurrence of sleep disturbances and the exposure to childhood trauma, which are found to differentially affect men and women, are also putative underlying mechanisms of the clinical bias of depression. Overall, by taking into account major differences which characterize men and women it might be possible to improve the diagnostic process, as well as treat more efficiently depressed individuals, based on a more personalized medicine and research.
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Affiliation(s)
- Maria Grazia Di Benedetto
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy,
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy,
| | - Paola Landi
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Annamaria Cattaneo
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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13
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Stoll F, Blank A, Mikus G, Czock D, Weiss J, Meyer-Tönnies MJ, Gümüs KS, Tzvetkov M, Burhenne J, Haefeli WE. Evaluation of Hydroxychloroquine as a Perpetrator on Cytochrome P450 (CYP) 3A and CYP2D6 Activity with Microdosed Probe Drugs in Healthy Volunteers. Eur J Drug Metab Pharmacokinet 2024; 49:101-109. [PMID: 38114885 PMCID: PMC10781839 DOI: 10.1007/s13318-023-00872-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND OBJECTIVE Although polypharmacy is a particular challenge in daily rheumatological practice, clinical research on the effects of hydroxychloroquine (HCQ), a commonly used drug for patients with rheumatic diseases, is sparse on cytochrome P450 (CYP)-mediated metabolism. We have shown that pre-treatment with pantoprazole does not alter HCQ absorption in healthy volunteers. In this paper, we report the effects of a single 400 mg dose of HCQ on specific CYP3A and CYP2D6 substrates in healthy volunteers. METHODS In the trial, participants were randomized into two groups (HCQ plus a 9-day course of pantoprazole, or HCQ only). As a secondary endpoint, the effects of a single oral dose of HCQ on the exposure of the oral microdosed CYP3A probe drug midazolam (30 μg) and the oral microdosed CYP2D6 probe drug yohimbine (50 μg) were studied in 23 healthy volunteers (EudraCT no. 2020-001470-30, registered 31 March 2020). RESULTS The exposure of the probe drugs after intake of HCQ compared with baseline values was quantified by the partial area under the plasma concentration-time curve 0-6 h after administration (AUC0-6 h) for yohimbine and the partial AUC2-4 h for midazolam. Under HCQ, yohimbine AUC0-6 h was unchanged, independent of CYP2D6 genotypes and pantoprazole exposure. Midazolam AUC2-4 h was 25% higher on the day of HCQ administration than at baseline (p = 0.0007). This significant increase was driven by the pantoprazole subgroup, which showed a 46% elevation of midazolam AUC2-4 h as compared with baseline (p < 0.0001). The ratio of midazolam to 1-OH-midazolam partial AUC2-4 h significantly increased from 3.03 ± 1.59 (baseline) to 3.60 ± 1.56 (HCQ) in the pantoprazole group (p = 0.0026). CONCLUSION In conclusion, we observed an increased midazolam exposure most likely related to pantoprazole.
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Affiliation(s)
- Felicitas Stoll
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
| | - Antje Blank
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Johanna Weiss
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Marleen J Meyer-Tönnies
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Greifswald, Germany
| | - Katja S Gümüs
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Mladen Tzvetkov
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Greifswald, Germany
| | - Jürgen Burhenne
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
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14
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Zhang J, Wen Y, Yin Y, Zhang Y, Zhang R, Zhang X, Ye J, Feng Y, Meng H. Impression life with pulmonary hypertension: clinically relevant characteristics and quality of life among patients in Gansu, China. Ther Adv Respir Dis 2024; 18:17534666241246428. [PMID: 38676370 PMCID: PMC11055475 DOI: 10.1177/17534666241246428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The adverse effects of pulmonary arterial hypertension (PAH) on physical, emotional, and health-related quality of life (HRQoL) remain primarily unrecognized, especially in resource-limited settings. OBJECTIVES This study aims to characterize the HRQoL of patients with PAH in this area and also identify the potential role of clinically relevant characteristics, including the 6-min walk distance test (6MWD), WHO-Functional Classification (WHO-FC), and mental health in the occurrence of lowering quality of life. DESIGN This was a cross-sectional observational study. METHODS Inpatients with PAH were chosen from a tertiary hospital located in Gansu province, China. All participants were interviewed face-by-face by using questionnaires, including items from the 36-Item Short Form Health Survey (SF-36), the self-rating anxiety scale, and the self-rating depression scale. Data on demographic and clinically relevant characteristics, including WHO-FC and 6MWD, were also collected by tracing medical recorders. Multiple linear regression analysis was used to determine the association between demographic, clinically relevant characteristics data, and physical component summary (PCS) or mental component summary (MCS) in SF-36. RESULTS Of the 152 participants, SF-36 differed significantly from Chinese norms in all eight domains, with role-physical (21.55 ± 9.87) less than one-third of the norm (88.79 ± 28.49). Multiple linear regression results showed that the factors with the greatest impact on PCS were anxiety scores (β = -0.22, p = 0.001), followed by WHO-FC (β = -0.16, p = 0.014) and 6MWD (β = 0.15, p = 0.036). The factors with the greatest impact on MCS were WHO-FC (β = -0.30, p < 0.001), followed by anxiety (β = -0.23, p = 0.001) and depression scores (β = -0.16, p = 0.013). CONCLUSION HRQoL was substantially reduced among PAH patients in the resource-limited area, mainly the physiological functions. WHO-FC and anxiety scores were independently associated with both PCS and MCS in SF-36. Clinicians should make reasonable rehabilitation programs and plans for patients according to their cardiac function grade and the severity of clinical symptoms. In addition, psychological interventions should also be taken, especially for those with anxiety symptoms, so as to improve their HRQoL.
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Affiliation(s)
- Juxia Zhang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Yujie Wen
- Cardiovascular Department, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Yuhuan Yin
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Yiyin Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Rong Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiaoli Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jianying Ye
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Yuping Feng
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Hongyan Meng
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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15
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Sun K, Eudy AM, Harris N, Pisetsky DS, Criscione-Schreiber LG, Sadun RE, Doss J, Clowse MEB, Rogers JL. Using PROMIS-29 to determine symptom burdens in the context of the Type 1 and 2 systemic lupus erythematosus (SLE) model: a cross sectional study. J Patient Rep Outcomes 2023; 7:136. [PMID: 38127169 PMCID: PMC10739689 DOI: 10.1186/s41687-023-00678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To account for heterogeneity in systemic lupus erythematosus (SLE) and bridge discrepancies between patient- and physician-perceived SLE activity, we developed the Type 1 and 2 SLE model. We examined PROMIS-29 scores, a composite patient-reported outcome (PRO) measure, through the lens of the model. METHODS Patients completed PROMIS-29 and the polysymptomatic distress scale (PSD). Rheumatologists completed the SLE disease activity index (SLEDAI), and physician's global assessments (PGAs) for Type 1 and 2 SLE. We defined Type 1 SLE using SLEDAI, Type 1 PGA, and active nephritis, and Type 2 SLE using PSD and Type 2 PGA. We compared PROMIS-29 T-scores among Type 1 and 2 SLE groups and explored whether PROMIS-29 can predict Type 1 and 2 SLE activity. RESULTS Compared to the general population, patients with isolated Type 1 SLE reported greater pain and physical dysfunction but less depression and improved social functions; patients with high Type 2 SLE (irrespective of Type 1 activity) reported high levels of pain, fatigue, and social and physical limitations. Patients with minimal Type 1 and 2 SLE had less depression and greater physical functioning with other domains similar to national norms. PROMIS-29 predicted Type 2 but not Type 1 SLE activity. CONCLUSION PROMIS-29 similarities in patients with high Type 2 SLE, with and without active Type 1 SLE, demonstrate the challenges of using PROs to assess SLE inflammation. In conjunction with the Type 1 and 2 SLE model, however, PROMIS-29 identified distinct symptom patterns, suggesting that the model may help clinicians interpret PROs.
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Affiliation(s)
- Kai Sun
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA.
| | - Amanda M Eudy
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
| | - Nathaniel Harris
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
| | - David S Pisetsky
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Lisa G Criscione-Schreiber
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
| | - Rebecca E Sadun
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
| | - Jayanth Doss
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
| | - Megan E B Clowse
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
| | - Jennifer L Rogers
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, DUMC 2978, Durham, NC, 27710, USA
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Dey M, Doskaliuk B, Lindblom J, Nikiphorou E, Wincup C, Fathima M, Saha S, Shaharir SS, Katchamart W, Goo PA, Traboco L, Chen YM, Kadam E, Lilleker JB, Nune A, Pauling JD, Agarwal V, Dey D, Toro Gutierrez CE, Caballero CV, Chinoy H, Aggarwal R, Agarwal V, Gupta L, Parodis I. COVID-19 Vaccination-Related Delayed Adverse Events among Patients with Systemic Lupus Erythematosus. J Clin Med 2023; 12:7542. [PMID: 38137611 PMCID: PMC10743599 DOI: 10.3390/jcm12247542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/25/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The safety profile of COVID-19 vaccination is well documented, but hesitancy among people with immune-mediated inflammatory diseases, often immunocompromised, remains high, partially due to a scarcity of data on safety over a longer term. We herein aimed to assess delayed adverse events (DAEs) occurring >7 days after COVID-19 vaccination in systemic lupus erythematosus (SLE) versus other rheumatic autoimmune diseases (rAIDs), non-rheumatic AIDs (nrAIDs), and healthy controls (HCs). METHODS Self-reported data were captured within the COVID-19 Vaccination in Autoimmune Diseases (COVAD)-2 online survey, which comprised >150 centres and responses from 106 countries, between February and June 2022. Logistic regression analysis adjusting for important confounders (age, sex, ethnicity) was used to compare groups. RESULTS Of 7203 eligible individuals, 882 (12.2%) patients had SLE, 3161 (43.9%) patients had rAIDs, 426 (5.9%) patients had nrAIDs, and 2734 (38.0%) were HCs. SLE patients had a median age of 39 years (IQR: 31-50); 93.7% were women. SLE patients reported, more frequently, major DAEs (OR: 1.6; 95% CI: 1.2-2.0; p = 0.001) and hospitalisation (OR: 2.2; 95% CI: 1.4-3.4; p < 0.001) compared to HCs, severe rashes (OR: 2.4; 95% CI: 1.3-4.2; p = 0.004) compared to people with rAIDS, and hospitalisation (OR: 2.3; 95% CI: 1.1-4.9; p = 0.029) as well as several minor DAEs compared to people with nrAIDs. Differences were observed between vaccines in terms of frequency of major DAEs and hospitalisations, with the latter seen more frequently in patients receiving the Moderna vaccine. People with SLE with no autoimmune multimorbidity less frequently reported overall minor DAEs compared to SLE patients with comorbid nrAIDs (OR: 0.5; 95% CI: 0.3-1.0; p = 0.036). CONCLUSION Hospitalisations post-vaccination were more frequent in SLE patients than in HCs. Monitoring of SLE patients following COVID-19 vaccination can help in identifying DAEs early, informing patients about expected DAEs, and supporting patients, especially those with autoimmune multimorbidity.
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Affiliation(s)
- Mrinalini Dey
- Centre for Rheumatic Diseases, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK; (M.D.); (E.N.)
| | - Bohdana Doskaliuk
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, 76018 Ivano-Frankivsk, Ukraine;
| | - Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden; (J.L.); (M.F.)
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK; (M.D.); (E.N.)
- Rheumatology Department, King’s College Hospital, London SE5 9RS, UK;
| | - Chris Wincup
- Rheumatology Department, King’s College Hospital, London SE5 9RS, UK;
| | - Madiha Fathima
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden; (J.L.); (M.F.)
| | - Sreoshy Saha
- Mymensingh Medical College, Mymensingh 2200, Bangladesh;
| | | | - Wanruchada Katchamart
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10100, Thailand; (W.K.); (COVAD Study Group)
| | | | - Lisa Traboco
- Department of Medicine, Section of Rheumatology, St. Luke’s Medical Center-Global City, Taguig 1630, Philippines
| | - Yi-Ming Chen
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 402, Taiwan;
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 402, Taiwan
| | - Esha Kadam
- Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai 400001, Maharashtra, India;
| | - James B. Lilleker
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK; (J.B.L.); (H.C.); (L.G.)
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford M16 0TT, UK
| | - Arvind Nune
- Southport and Ormskirk Hospital NHS Trust, Southport PR8 6PN, UK;
| | - John D. Pauling
- Bristol Medical School Translational Health Sciences, University of Bristol, Bristol BS8 1QU, UK;
- Department of Rheumatology, North Bristol NHS Trust, Bristol BS9 4RJ, UK
| | - Vishwesh Agarwal
- Mahatma Gandhi Mission Medical College, Navi Mumbai 401208, Maharashtra, India;
| | - Dzifa Dey
- Rheumatology Unit, Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, Korle-Bu, Accra KB 460, Ghana;
| | - Carlos Enrique Toro Gutierrez
- Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Cali 760046, Colombia;
| | | | - Hector Chinoy
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK; (J.B.L.); (H.C.); (L.G.)
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford M6 8HD, UK
| | - COVAD Study Group
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10100, Thailand; (W.K.); (COVAD Study Group)
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA;
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India;
| | - Latika Gupta
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK; (J.B.L.); (H.C.); (L.G.)
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton WV10 0QP, UK
- Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B71 4HJ, UK
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden; (J.L.); (M.F.)
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, 70281 Örebro, Sweden
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Liang Q, Wang X, He Q, Ni X, Zhao R, Ji J, Dong C, Gu Z. Factors associated with fertility intention among women with systemic lupus erythematosus in China: A cross-sectional study. Int J Rheum Dis 2023; 26:2419-2429. [PMID: 37849430 DOI: 10.1111/1756-185x.14927] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE This study aims to explore the status and influencing factors of fertility intention in women of childbearing age with systemic lupus erythematosus (SLE). METHODS A total of 158 SLE patients admitted to the Affiliated Hospital of Nantong University from February 2021 to February 2022 were selected for a cross-sectional study. The dependent variable in this study was the fertility intention of lupus women of childbearing age, so the questionnaire was selected: "In view of your disease, do you plan to have children? Yes/no" as the measurement statement. Lupus patients were divided into fertility intention groups and non-fertility intention groups. The questionnaire survey comprises following scales: Hospital Anxiety and Depression Scale (HADS), Multidimensional Fatigue Inventory (MFI-20), Female Sexual Distress Scale-Revised (FSDS-R), and others. Independent t-test, one-way ANOVA, Mann-Whitney U test, and binary logistic regression were used for analysis. RESULTS The results showed that 20.9% of lupus patients in this study had a fertility intention. The fertility intention was associated with age, reproductive history, reproductive concerns, sexual distress, fatigue, family function, social support, depression, and sleep. Binary logistic regression showed that physical fatigue (OR 3.56, 95% CI 1.048-12.07) and personal health (OR 2.50, 95% CI 1.065-5.853) had significant predictors of fertility intention. CONCLUSION Our study identified a lower fertility intention in SLE patients who had reproductive concerns, sexual distress, family dysfunction, and fatigue. We encourage healthcare institutions to provide counseling services to all the SLE patients who have fertility intention and focus more on those who have requirements for fertility.
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Affiliation(s)
- Qian Liang
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Xingxin Wang
- Department of Pulmonary and Critical care Medicine, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qian He
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Xiaowei Ni
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Rui Zhao
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Juan Ji
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Chen Dong
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Zhifeng Gu
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
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18
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Aw E, Zhang Y, Yalcin E, Herrmann U, Lin SL, Langston K, Castrillon C, Ma M, Moffitt JR, Carroll MC. Spatial enrichment of the type 1 interferon signature in the brain of a neuropsychiatric lupus murine model. Brain Behav Immun 2023; 114:511-522. [PMID: 37369340 PMCID: PMC10918751 DOI: 10.1016/j.bbi.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/01/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023] Open
Abstract
Among systemic lupus erythematosus (SLE) patients, neuropsychiatric symptoms are highly prevalent, being observed in up to 80% of adult and 95% of pediatric patients. Type 1 interferons, particularly interferon alpha (IFNα), have been implicated in the pathogenesis of SLE and its associated neuropsychiatric symptoms (NPSLE). However, it remains unclear how type 1 interferon signaling in the central nervous system (CNS) might result in neuropsychiatric sequelae. In this study, we validate an NPSLE mouse model and find an elevated peripheral type 1 interferon signature alongside clinically relevant NPSLE symptoms such as anxiety and fatigue. Unbiased single-nucleus sequencing of the hindbrain and hippocampus revealed that interferon-stimulated genes (ISGs) were among the most highly upregulated genes in both regions and that gene pathways involved in cellular interaction and neuronal development were generally repressed among astrocytes, oligodendrocytes, and neurons. Using image-based spatial transcriptomics, we found that the type 1 interferon signature is enriched as spatially distinct patches within the brain parenchyma of these mice. Our results suggest that type 1 interferon in the CNS may play an important mechanistic role in mediating NPSLE behavioral phenotypes by repressing general cellular communication pathways, and that type 1 interferon signaling modulators are a potential therapeutic option for NPSLE.
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Affiliation(s)
- Ernest Aw
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States; Division of Medical Sciences, Harvard Medical School, Boston, MA, United States
| | - Yingying Zhang
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Esra Yalcin
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Uli Herrmann
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Stacie L Lin
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States; Division of Medical Sciences, Harvard Medical School, Boston, MA, United States
| | - Kent Langston
- Department of Immunology, Harvard Medical School and Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Carlos Castrillon
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Minghe Ma
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Michael C Carroll
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.
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Chessa E, Piga M, Perra A, Pintus E, Porcu M, Serafini C, Congia M, Angioni MM, Naitza MR, Floris A, Mathieu A, Saba L, Carta MG, Cauli A. Effect of anti-P ribosomal and anti-NR2 antibodies on depression and cognitive processes in SLE: an integrated clinical and functional MRI study. Lupus Sci Med 2023; 10:e001005. [PMID: 37918951 PMCID: PMC10626760 DOI: 10.1136/lupus-2023-001005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES To explore the effects of anti-ribosomal P protein (anti-P) and anti-N-methyl-D-aspartic acid receptor subunit 2 (anti-NR2) autoantibodies on depression and cognitive dysfunction and their relationships with functional brain connectivity in SLE. METHODS This cross-sectional study included adult patients who fulfilled the American College of Rheumatology/European Alliance of Associations for Rheumatology 2019 SLE criteria. Anti-P and anti-NR2 were quantified using ELISA. A 1-hour battery of neuropsychological testing interpreted by a neuropsychologist explored depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D), cognitive domains and quality of life (SF-12). Resting-state functional connectivity (rs-fc) MRI analysis was performed within 1 month, and region-of-interest to region-of-interest (ROI-to-ROI) analyses with the graph theory were performed. RESULTS Thirty-three patients with SLE (9% male) were enrolled, mean age (SD) of 43.5 (14) years and median disease duration of 10.4 years (2.9-25.4). Anti-P was positive in 6 (18.2%) and anti-NR2 in 14 (42.4%) patients. Depressive symptoms were found in 14 (42.4%) patients using the CES-D (range 0-51). After correction for age, disease duration, disease activity and white matter lesion load, the CES-D score was independently associated with anti-P serum level (β=0.32; p=0.049) and prednisone daily dose (β=0.38; p=0.023). Nineteen patients (57.6%) showed at least a cognitive test alteration, but no significant association with autoantibodies was found. The rs-fc MRI analysis revealed an independent association between the anti-P serum levels and many altered brain ROI properties but no anti-NR2 and prednisone effects on the cerebral network. CONCLUSIONS Anti-P was associated with brain network perturbation, which may be responsible for depressive symptoms in patients with SLE.
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Affiliation(s)
| | - Matteo Piga
- Rheumatology Unit, AOU Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michele Porcu
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Cristina Serafini
- Rheumatology Unit, AOU Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Maria Maddalena Angioni
- Rheumatology Unit, AOU Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Micaela Rita Naitza
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alberto Floris
- Rheumatology Unit, AOU Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandro Mathieu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Radiology Department, AOU Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alberto Cauli
- Rheumatology Unit, AOU Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Shatri H, Purnamandala, Hidayat R, Sinto R, Widhani A, Putranto R, Purnamasari RD, Ginanjar E, Jasirwan COM. The correlation of anxiety and depression with C3 and C4 Levels and systemic lupus erythematosus activity. BMC Psychiatry 2023; 23:785. [PMID: 37884917 PMCID: PMC10604414 DOI: 10.1186/s12888-023-05285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Anxiety and depression are psychosomatic disorders that are frequently observed in chronic conditions such as systemic lupus erythematosus (SLE). Anxiety and depression can be induced by immunological and neurotransmitter dysregulation, which is characterized by hypothalamic-pituitary-adrenal (HPA) axis dysfunction, production of proinflammatory cytokines, and activation of complement in the blood, such as C3 and C4. The causes of anxiety and depression in SLE are complex, ranging from neuropsychiatric involvement to drug adverse effects. Detecting anxiety and depression symptoms in SLE patients is critical to preventing disability from impacting quality of life. OBJECTIVE To assess the relationship between anxiety and depression symptomatology, SLE disease activity with levels of C3 and C4 in Cipto Mangunkusumo National Hospital. METHODS This study used a cross-sectional design. The study included 120 SLE patients from Cipto Mangunkusumo National Hospital, aged 18 to 60 years. All patients were requested to complete a Hospital Anxiety and Depression Scale (HADS) questionnaire to assess their anxiety and depression symptoms. Subjects with anxiety and depression were assessed for disease activity using the Mexican Systemic Lupus Erythematosus Systemic Disease Activity (Mex-SLEDAI), and blood samples were collected to test complement C3 and C4 levels. Spearman's correlation test was used to examine the relationship between HADS scores, Mex-SLEDAI, and C3 and C4 levels. RESULTS The results of the study showed a very weak statistically significant negative correlation between anxiety symptoms based on HADS and C3 levels (r = -0.189; p = 0.038) and a weak correlation between anxiety symptoms and C4 levels (r = -204; p = 0.026). Depressive symptoms based on HADS revealed a very poor connection and no statistical significance with levels of C3 (r = -0.056; p = 0.546) and C4 (r = -0.068; p = 0.461). Anxiety (r = 0.06; p = 0.173) and depression (r = 0.031; p = 0.753) symptoms have a weak and insignificant positive connection with SLE activity. CONCLUSION C3 and C4 serum levels appeared to decrease when the presence of anxious symptoms increased. There was no significant correlation in SLE disease activity between anxious and depressed patients.
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Affiliation(s)
- Hamzah Shatri
- Division of Psychosomatic and Palliative, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
| | - Purnamandala
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Rudy Hidayat
- Division of Rheumatology, Department of Internal, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Robert Sinto
- Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/ Cipto Mangunkusumo Referral National Hospital, Jakarta, Indonesia
| | - Alvina Widhani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Rudi Putranto
- Division of Psychosomatic and Palliative, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Rr Dyah Purnamasari
- Division of Endocrinology Metabolism and Diabetes, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Eka Ginanjar
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Chyntia Olivia Maurine Jasirwan
- Division oh Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
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21
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Chen GF, Shaw KS, Sanchez-Melendez S, Vleugels RA, Cohen JM. Increased risk of depression in patients with discoid lupus erythematosus: a nested, case-control study in the All of Us Research Program. Br J Dermatol 2023; 189:628-629. [PMID: 37461222 DOI: 10.1093/bjd/ljad239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/07/2023] [Accepted: 08/05/2023] [Indexed: 10/27/2023]
Abstract
In this nested case–control study, we found a twofold increased risk of major depressive disorder in patients with discoid lupus erythematosus (DLE) vs. controls without DLE, using the All of Us database, a National Institutes of Health (USA) research programme that prioritizes recruitment from demographic groups under-represented in biomedical research. This is the first large-scale study of this association in a heterogeneous population and highlights the importance vigilance regarding the increased risk of depression in patients with DLE.
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Affiliation(s)
| | - Katharina S Shaw
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | | | - Ruth Ann Vleugels
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
- Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA
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Kiani Z, Fakari FR, Hakimzadeh A, Hajian S, Fakari FR, Nasiri M. Prevalence of depression in infertile men: a systematic review and meta-analysis. BMC Public Health 2023; 23:1972. [PMID: 37821902 PMCID: PMC10568846 DOI: 10.1186/s12889-023-16865-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men. METHODS This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively. RESULTS Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively. CONCLUSION Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.
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Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Rashidi Fakari
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atena Hakimzadeh
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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23
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Camones-Huerta J, Arias-Osorio C, Rodriguez-Hurtado D, Aguilar-Olano J. Neuropsychiatric Manifestations in Systemic Lupus Erythematosus Patients at a Tertiary Hospital in Peru. Eur J Rheumatol 2023; 10:143-147. [PMID: 37850607 PMCID: PMC10765184 DOI: 10.5152/eurjrheum.2023.22095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 08/02/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Systemic lupus erythematosus is a prevalent autoimmune disease that affects multiples systems, exerting its most incapacitating and life-threatening impact through neuropsychiatric involvement. According to the American College of Rheumatology (ACR), 19 neuropsychiatric syndromes types of SLE are classified into categories encompassing the central and peripheral nervous systems. This study aimed to investigate the frequency of neuropsychiatric manifestations in systemic lupus erythematosus patients admitted to Hospital Cayetano Heredia in Lima, Peru, between 2008 and 2019. METHODS A retrospective observational study was conducted, entailing the review of 240 medical records of patients diagnosed with systemic lupus erythematosus during the specified period, based on the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria. Among these records, 55 patients presented neuropsychiatric systemic lupus erythematosus (NPSLE). Data were collected using standardized form and entered into Microsoft Excel 2019 database. Statistical analysis was performed using Stata v16. RESULTS The frequency of neuropsychiatric compromise in systemic lupus erythematosus patients was found to be 22.91%. Among the 55 systemic lupus erythematosus patients, 40 demonstrated involvement of the central nervous system (72.72%), 2 exhibited involvement of the peripheral nervous system (3.63%), and 13 displayed involvement in both the central nervous system and peripheral nervous system (23.63%). The most prevalent psychiatric disorder observed was a major depressive disorder, with a prevalence rate of 30.9%. CONCLUSION The study revealed a frequency of 22.91% for neuropsychiatric involvement in systemic lupus erythematosuspatients at Cayetano Heredia Hospital between 2008 and 2019, with central nervous system manifestations prevailing. Furthermore, the findings suggest that NPSLE commonly manifested after the diagnosis of systemic lupus erythematosus.
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Dehghan A, Soltani H, Faezi ST, Baghdadi A, Soleymani Salehabadi H, Bashiri H, Hemayati R, Mansouri M, Motaghi M, Nejadhosseinian M. Depression, anxiety, and quality of life in patients with systemic lupus erythematosus. Reumatologia 2023; 61:368-374. [PMID: 37970122 PMCID: PMC10634407 DOI: 10.5114/reum/168396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 06/15/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Systemic lupus erythematosus (SLE) is a multisystem disorder that can affect multiple organs; psychiatric manifestations including depression and anxiety are commonly seen in SLE. The aim of this study is to explore the prevalence of depression, anxiety, and stress, and assess the quality of life (QOL) in patients with SLE and also evaluate associated risk factors. Material and methods In this cross-sectional study, adult patients with SLE were identified through our institution's SLE data registry. Participants were evaluated with three questionnaires: Depression, Anxiety, and Stress Scale (DASS-42), General Health Ouestionnaire-28 (GHQ-28), and World Health Organization quality of life instrument short form (WHO-QOL BREF). Results A total of 222 patients were included in the study, 203 (91%) of whom were female and 19 were male (9%). Participants had a mean age of 35.6 ±9.5 years. According to DASS-42 questionnaire, 22.1%, 28.7% and 20.3% of patients had varying degrees of depression, anxiety, and stress, respectively. Based on GHQ-28 questionnaire, 137 (62%) of patients reported some degree of distress. Quality of life score was 12.8, 13, 14.3, and 13.9 in physical health, psychological health, social relationships, and environmental health, respectively. Conclusions We found that depression, anxiety, and stress are common in patients with SLE, and quality of life is significantly affected. A high percentage of patients with SLE deal with some degree of distress. Routine evaluation of the quality of life and psychological disturbances is recommended in patients with SLE. Non-pharmacological interventions as well as specialist referral should be considered in patients with anxiety, depression, or stress.
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Affiliation(s)
- Ali Dehghan
- Rheumatology Research Center, Tehran University of Medical Sciences, Iran
| | - Hamidreza Soltani
- Department of Internal Medicine, Rheumatology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Azarakhsh Baghdadi
- Rheumatology Research Center, Tehran University of Medical Sciences, Iran
| | - Hossein Soleymani Salehabadi
- Department of Internal Medicine, Rheumatology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Bashiri
- Department of Internal Medicine, Rheumatology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Roya Hemayati
- Department of Internal Medicine, Nephrology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehrdad Mansouri
- Health System Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Motaghi
- Rheumatology Research Center, Tehran University of Medical Sciences, Iran
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Topaloudi A, Jain P, Martinez MB, Bryant JK, Reynolds G, Zagoriti Z, Lagoumintzis G, Zamba-Papanicolaou E, Tzartos J, Poulas K, Kleopa KA, Tzartos S, Georgitsi M, Drineas P, Paschou P. PheWAS and cross-disorder analysis reveal genetic architecture, pleiotropic loci and phenotypic correlations across 11 autoimmune disorders. Front Immunol 2023; 14:1147573. [PMID: 37809097 PMCID: PMC10552152 DOI: 10.3389/fimmu.2023.1147573] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Autoimmune disorders (ADs) are a group of about 80 disorders that occur when self-attacking autoantibodies are produced due to failure in the self-tolerance mechanisms. ADs are polygenic disorders and associations with genes both in the human leukocyte antigen (HLA) region and outside of it have been described. Previous studies have shown that they are highly comorbid with shared genetic risk factors, while epidemiological studies revealed associations between various lifestyle and health-related phenotypes and ADs. Methods Here, for the first time, we performed a comparative polygenic risk score (PRS) - Phenome Wide Association Study (PheWAS) for 11 different ADs (Juvenile Idiopathic Arthritis, Primary Sclerosing Cholangitis, Celiac Disease, Multiple Sclerosis, Rheumatoid Arthritis, Psoriasis, Myasthenia Gravis, Type 1 Diabetes, Systemic Lupus Erythematosus, Vitiligo Late Onset, Vitiligo Early Onset) and 3,254 phenotypes available in the UK Biobank that include a wide range of socio-demographic, lifestyle and health-related outcomes. Additionally, we investigated the genetic relationships of the studied ADs, calculating their genetic correlation and conducting cross-disorder GWAS meta-analyses for the observed AD clusters. Results In total, we identified 508 phenotypes significantly associated with at least one AD PRS. 272 phenotypes were significantly associated after excluding variants in the HLA region from the PRS estimation. Through genetic correlation and genetic factor analyses, we identified four genetic factors that run across studied ADs. Cross-trait meta-analyses within each factor revealed pleiotropic genome-wide significant loci. Discussion Overall, our study confirms the association of different factors with genetic susceptibility for ADs and reveals novel observations that need to be further explored.
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Affiliation(s)
- Apostolia Topaloudi
- Department of Biological Sciences, Purdue University, West Lafayette, IN, United States
| | - Pritesh Jain
- Department of Biological Sciences, Purdue University, West Lafayette, IN, United States
| | - Melanie B. Martinez
- Department of Biological Sciences, Purdue University, West Lafayette, IN, United States
| | - Josephine K. Bryant
- Department of Biological Sciences, Purdue University, West Lafayette, IN, United States
| | - Grace Reynolds
- Department of Biological Sciences, Purdue University, West Lafayette, IN, United States
- West Lafayette High School, West Lafayette, IN, United States
| | - Zoi Zagoriti
- Department of Pharmacy, University of Patras, Rio, Greece
| | | | - Eleni Zamba-Papanicolaou
- Department of Neuroepidemiology and Centre for Neuromuscular Disorders, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - John Tzartos
- B’ Neurology Department, School of Medicine, National & Kapodistrian University of Athens, “Attikon” University Hospital., Athens, Greece
| | | | - Kleopas A. Kleopa
- Department of Neuroscience and Centre for Neuromuscular Disorders, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Socrates Tzartos
- Department of Pharmacy, University of Patras, Rio, Greece
- Tzartos NeuroDiagnostics, Athens, Greece
| | - Marianthi Georgitsi
- Department of Molecular Biology and Genetics, School of Health Sciences, Democritus University of Thrace, Alexandroupoli, Greece
| | - Petros Drineas
- Department of Computer Science, Purdue University, West Lafayette, IN, United States
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, United States
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Aw E, Lin SL, Zhang Y, Herrmann U, Yalcin E, Langston K, Castrillion C, Ma M, Moffitt JR, Carroll MC. [WITHDRAWN] Spatial enrichment of the type 1 interferon signature in the brain of a neuropsychiatric lupus murine model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.21.537814. [PMID: 37131759 PMCID: PMC10153248 DOI: 10.1101/2023.04.21.537814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
bioRxiv has withdrawn this manuscript because it was posted without the consent of all authors. If you have any questions, please contact the corresponding author.
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Fu H, Fu Z, Mao M, Si L, Bai J, Wang Q, Guo R. Prevalence and prognostic role of PD-L1 in patients with gynecological cancers: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2023; 189:104084. [PMID: 37536446 DOI: 10.1016/j.critrevonc.2023.104084] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE Our study aims to evaluate programmed cell death ligand-1 (PD-L1) expression and its prognostic significance in cervical cancer (CC), endometrial cancer (EC) and ovarian cancer (OC). METHODS Several electronic databases were searched. Fixed effects models or random effects models were employed to calculate the pooled prevalence of PD-L1 positivity and pooled hazard ratios (HRs) as appropriate. Heterogeneity and publication bias were also assessed. RESULTS The pooled prevalence of PD-L1 positivity was 58.1%, 33.8% and 37.5% for CC, EC and OC patients, respectively. There were significant differences in the pooled estimates after stratification by PD-L1-positive assessment criteria and antibody clones. PD-L1 positivity was associated with worse OS in CC and EC patients and poorer progression-free survival (PFS) in CC patients. CONCLUSIONS The prevalence of PD-L1-positive expression was considerably high in CC and modestly high in EC and OC patients. PD-L1 expression has the potential to be a prognostic biomarker for predicting the clinical outcomes of patients with CC and EC but not OC.
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Affiliation(s)
- Hanlin Fu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhihui Fu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Meng Mao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lulu Si
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jing Bai
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qian Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ruixia Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Blamires J, Foster M, Napier S, Dickinson A. Experiences and Perspectives of Children and Young People Living with Childhood-Onset Systemic Lupus Erythematosus-An Integrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1006. [PMID: 37371240 DOI: 10.3390/children10061006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/16/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
Childhood-onset systemic lupus erythematosus (cSLE) impacts the daily life of children and young people. This study aimed to describe the experiences and perspectives of children and young people living with cSLE. An integrative review guided by Whittemore and Knafl was conducted. Extant empirical research published in peer-reviewed journals from 2000 to 2021 on children's self-reported experiences living with cSLE was identified from Scopus, CINAHL, Medline via PubMed, and PsycINFO via Ovid databases. Nineteen studies involving over 1400 participants were included. Four themes and fourteen sub-themes were identified: (1) challenging symptoms (disruptions to life and altered self, severity, fatigue, depression, and anxiety), (2) medicines and side effects (dreaded steroids, conflicting feelings, and medication adherence), (3) complicated life (school sports and social, giving things up, lack of understanding, and quality of life) and (4) ways of coping (family and friends, relationships with health providers, and maintaining positivity). While cSLE shares many similarities with adult-onset SLE, awareness of differences in experiences and perceptions of children and young people is crucial. The significant psychological and social impact of the disease and its treatments necessitates a comprehensive, holistic approach to managing cSLE that considers the unique needs of youth.
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Affiliation(s)
- Julie Blamires
- School of Clinical Sciences, Auckland University of Technology, Auckland 0627, New Zealand
| | - Mandie Foster
- School of Clinical Sciences, Auckland University of Technology, Auckland 0627, New Zealand
- School of Nursing and Midwifery, Edith Cowan University, Perth 6027, Australia
| | - Sara Napier
- School of Clinical Sciences, Auckland University of Technology, Auckland 0627, New Zealand
| | - Annette Dickinson
- School of Clinical Sciences, Auckland University of Technology, Auckland 0627, New Zealand
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Pasyar N, Sam A, Rivaz M, Nazarinia M. A smartphone-based supportive counseling on health anxiety and acceptance of disability in Systemic Lupus Erythematosus patients: A randomized clinical trial. PATIENT EDUCATION AND COUNSELING 2023; 110:107676. [PMID: 36841083 DOI: 10.1016/j.pec.2023.107676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effects of a supportive counseling via the smart phone on the health anxiety, and acceptance of disability in the patients with Systemic Lupus Erythematosus. METHODS The present study was a randomized clinical trial with pre-post design. Randomly dividing 124 patients into experimental and control groups. Before and after the intervention, all patients answered the health anxiety and disability acceptance questionnaires. For eight weeks, the trial group received remote counseling help using the WhatsApp platform. RESULTS All 124 patients randomized into groups, completed follow-up which were analyzed. By the end of 8th week, the level of health anxiety (MD=11.34, P < 0.001) of the experiment group was significantly lower than the control group, while the level of acceptance of disability (MD=91.42, P < 0.001) of experiment group was significantly higher than the control group. CONCLUSION Smartphone-based supportive counseling may help people with Systemic Lupus Erythematosus manage their symptoms better, and live better by reducing health worry and increasing acceptance of impairment. PRACTICE IMPLICATIONS Virtual supportive counseling can assist healthcare professionals to optimize the potential of education and support processes.
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Affiliation(s)
- Nilofar Pasyar
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Sam
- Student Research Committee,Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Rivaz
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammadali Nazarinia
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Nassar EL, Abdulkareem DA, Thombs BD. Results from a living systematic review of the prevalence of mood and anxiety disorders and factors associated with symptoms in systemic sclerosis. Sci Rep 2023; 13:5181. [PMID: 36997795 PMCID: PMC10063612 DOI: 10.1038/s41598-023-31919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
We aimed to synthesize evidence on (1) the prevalence of mood and anxiety disorders and (2) factors associated with symptoms in systemic sclerosis (SSc). We searched MEDLINE, CINAHL, EMBASE, Cochrane CENTRAL, and PsycINFO via an ongoing living systematic review with automated monthly searches. We identified 6 eligible studies through March 1, 2023. Based on 3 studies (N = 93 to 345), current or 30-day major depressive disorder prevalence was 4% (95% confidence interval [CI] 2%, 6%) in a sample of Canadian outpatients (N = 345), 18% (95% CI 12%, 27%) in a study of Indian outpatients (N = 93), 10% (95% CI 4%, 21%) for French patient conference attendees (N = 51), and 29% (95% CI 18%, 42%) for French inpatients (N = 49). Current or 30-day prevalence of any anxiety disorder was 49% (95% CI 36%, 62%) for French conference attendees and 51% (95% CI 38%, 64%) for French inpatients; current or 30-day prevalence of generalized anxiety disorder was 3% for Indian outpatients (95% CI 1%, 9%; N = 93). In 3 studies (N = 114 to 376) that examined factors associated with depressive symptoms, higher education and being married or living as married were associated with lower symptoms and pulmonary involvement, breathing problems, and tender joint counts with higher symptoms; age and disease severity markers were not associated. Only 1 study (N = 114) assessed factors associated with anxiety symptoms and found no statistically significant associations. Limitations included heterogeneous populations and assessment methods, small samples, and substantial risk of bias concerns. Mood and anxiety disorder prevalence appear high in SSc, but estimates vary, and existing studies have important limitations. Future research should assess mood and anxiety prevalence and factors associated with symptoms using large representative samples and validated classification and assessment methods.Review registration: PROSPERO (CRD 42021251339).
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Affiliation(s)
- Elsa-Lynn Nassar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Pavilion H4.83, Montreal, QC, H3T 1E2, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Dalal A Abdulkareem
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Pavilion H4.83, Montreal, QC, H3T 1E2, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Pavilion H4.83, Montreal, QC, H3T 1E2, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
- Department of Psychology, McGill University, Montreal, QC, Canada.
- Department of Medicine, McGill University, Montreal, QC, Canada.
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada.
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Koletsos N, Dipla K, Triantafyllou A, Dolgyras P, Aslanidis S, Zafeiridis A, Galanopoulou V, Douma S, Gkaliagkousi E. Depression in systemic lupus erythematosus: A manifestation of microcirculation dysfunction? Lupus 2023; 32:727-736. [PMID: 36989458 DOI: 10.1177/09612033231167792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Depression is highly prevalent among systemic lupus erythematosus (SLE) patients. Brain hypoperfusion in neuropsychiatric SLE patients might be associated with emotional difficulties. However, no previous study examined possible associations of depression with brain oxygenation during a mild physical stress in non-neuropsychiatric SLE patients. Our study aimed to identify possible differences in cerebral oxygenation during exercise in SLE patients with and without depressive symptoms using near-infrared spectroscopy (NIRS) and examine possible underlying mechanisms through evaluation of vascular cell adhesion molecule 1 (VCAM-1) levels. METHODS SLE patients without a known neuropsychiatric history or treatment with antidepressants or antipsychotic drugs were enrolled. Participants were assigned into groups based on Beck's Depression Inventory I (BDI-I). Patients with BDI-I score ≥10 comprised the SLE-depression group and those with BDI-I score <9 the SLE-non-depression group. All participants underwent a protocol involving a seated rest, a 3-min handgrip exercise (at 30% of maximal strength), and a 3-min recovery. NIRS was used to monitor changes in cerebral oxygenated hemoglobin (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb). VCAM-1 levels were measured in serum samples. RESULTS Twenty-three patients were enrolled. During exercise, the SLE-depression group exhibited a significantly lower increase in cerebral O2Hb [(peak-O2Hb (p = 0.039); O2Hb-area under the curve, AUC, p = 0.027) vs. SLE-non-depression group. BDI-I score was inversely correlated with AUC (rho = -0.493, p = 0.017) and positively correlated with VCAM-1 levels (rho = 0.501, p = 0.034). CONCLUSION This study suggests a possible association between emotional abnormalities and microvascular impairment (cerebral oxygenation and endothelial dysfunction) in SLE However, larger studies are needed to confirm these results.
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Affiliation(s)
- Nikolaos Koletsos
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, 37782Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, 37782Aristotle University of Thessaloniki, Serres, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, 37782Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Dolgyras
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, 37782Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Spyros Aslanidis
- Rheumatology Department - 2nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, 37782Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, 37782Aristotle University of Thessaloniki, Serres, Greece
| | | | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, 37782Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, 37782Aristotle University of Thessaloniki, Thessaloniki, Greece
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Howren A, Avina-Zubieta JA, Puyat JH, Da Costa D, Xie H, Davidson E, Rebić N, Gastonguay L, Dau H, De Vera MA. Impact of Loneliness and Social Isolation on Mental Health Outcomes Among Individuals With Rheumatic Diseases During the COVID-19 Pandemic. ACR Open Rheumatol 2023; 5:243-250. [PMID: 36964954 PMCID: PMC10184014 DOI: 10.1002/acr2.11539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/05/2023] [Accepted: 02/12/2023] [Indexed: 03/27/2023] Open
Abstract
OBJECTIVE The study objective was to assess mental and social health outcomes for individuals with rheumatic disease during the COVID-19 pandemic and evaluate the relationship of loneliness and social isolation with depression and anxiety. METHODS We administered an international cross-sectional online survey to individuals with rheumatic disease(s) (≥18 years) between April 2020 and September 2020, with a follow-up survey from December 2020 to February 2021. We used questionnaires to evaluate loneliness (3-item UCLA Loneliness Scale [UCLA-3]), social isolation (Lubben Social Network Scale [LSNS-6]), depression (Patient Health Questionnaire [PHQ-9]), and anxiety (Generalized Anxiety Disorder 7-item [GAD-7] Scale). We used multivariable linear regression models to evaluate the cross-sectional associations of loneliness and social isolation with depression and anxiety at baseline. RESULTS Seven hundred eighteen individuals (91.4% women, mean age: 45.4 ± 14.2 years) participated in the baseline survey, and 344 completed the follow-up survey. Overall, 51.1% of participants experienced loneliness (UCLA-3 score ≥6) and 30.3% experienced social isolation (LSNS-6 score <12) at baseline. Depression (PHQ-9 score ≥10) and anxiety (GAD-7 score ≥10) were experienced by 42.8% and 34.0% of participants at baseline, respectively. Multivariable models showed that experiencing both loneliness and social isolation, in comparison to experiencing neither, was significantly associated with an average 7.27 higher depression score (ß = 7.27; 95% confidence interval [CI]: 6.08-8.47) and 5.14 higher anxiety score (ß = 5.14; 95% CI: 4.00-6.28). CONCLUSION Aside from showing substantial experience of loneliness and social isolation during the COVID-19 pandemic, our survey showed significant associations with depression and anxiety. Patient supports to address social health have potential implications for also supporting mental health.
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Affiliation(s)
- Alyssa Howren
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, and Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - J Antonio Avina-Zubieta
- University of British Columbia and Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - Joseph H Puyat
- University of British Columbia and Centre for Health Evaluation & Outcome Sciences, British Columbia, Vancouver, Canada
| | | | - Hui Xie
- Arthritis Research Canada, Vancouver, and Simon Fraser University, British Columbia, Burnaby, Canada
| | - Eileen Davidson
- Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - Nevena Rebić
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, and Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - Louise Gastonguay
- University of British Columbia and Collaboration for Outcomes Research and Evaluation, British Columbia, Vancouver, Canada
| | - Hallie Dau
- University of British Columbia and Collaboration for Outcomes Research and Evaluation, British Columbia, Vancouver, Canada
| | - Mary A De Vera
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, Arthritis Research Canada, and Centre for Health Evaluation & Outcome Sciences, British Columbia, Vancouver, Canada
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Rondepierre F, Tauveron-Jalenques U, Valette S, Mulliez A, D’Incan M, Lauron S, Jalenques I. Psychiatric symptomatology in skin-restricted lupus patients without axis I psychiatric disorders: A post-hoc analysis. PLoS One 2023; 18:e0282079. [PMID: 36857334 PMCID: PMC9977055 DOI: 10.1371/journal.pone.0282079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Skin-restricted lupus is a chronic inflammatory disease associated with high rates of depression and anxiety disorders. Patients without psychiatric disorders can experience anxiety and depressive symptoms at a subclinical level, which could be risk factors for progression towards psychiatric disorders. It was decided, therefore, to investigate the presence of specific symptoms in skin-restricted lupus patients without axis I psychiatric disorders and their impact on the occurrence of axis I psychiatric disorders during the study follow-up. METHODS Longitudinal data of 38 patients and 76 matched controls without active axis I psychiatric disorders from the LuPsy cohort were used. Depressive, neurovegetative, psychic and somatic anxiety symptom scores were established from the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Rating scale (HAMA). RESULTS None of the participants had any current active axis I psychiatric disorders but the patients had personality disorders more frequently and had received more past psychotropic treatments than the controls. They also had higher MADRS and HAMA scores than the controls, in particular neurovegetative, psychic anxiety and somatic symptoms scores. No dermatological factor tested was associated with these scores, whereas being a lupus patient was associated with higher neurovegetative and somatic symptoms scores, having a current personality disorder with higher depressive and neurovegetative scores and receiving more past psychotropic treatments with psychic anxiety and somatic symptoms scores. The occurrence of psychiatric disorders during the study follow-up was associated with an elevated psychic anxiety score at baseline and past psychotropic treatment but not with history of psychiatric disorder. LIMITATIONS The LuPsy cohort included a large number of patients with axis I psychiatric disorders, the sample without axis I psychiatric disorders is therefore limited. CONCLUSIONS We observed numerous psychiatric symptoms among the skin-restricted lupus patients. They should therefore receive special attention in the management of their subclinical symptoms before they progress towards full psychiatric disorders.
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Affiliation(s)
- Fabien Rondepierre
- CHU Clermont-Ferrand, Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Clermont-Ferrand, France
| | - Urbain Tauveron-Jalenques
- Clermont Auvergne Université, CNRS, CHU Clermont-Ferrand, Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Solène Valette
- Clermont Auvergne Université, CNRS, CHU Clermont-Ferrand, Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Aurélien Mulliez
- CHU Clermont-Ferrand, Direction de la Recherche Clinique et de l’Innovation, Clermont-Ferrand, France
| | - Michel D’Incan
- Clermont Auvergne Université, INSERM, CHU Clermont-Ferrand, Service de Dermatologie, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Sophie Lauron
- Clermont Auvergne Université, CNRS, CHU Clermont-Ferrand, Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Isabelle Jalenques
- Clermont Auvergne Université, CNRS, CHU Clermont-Ferrand, Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France,* E-mail:
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Kropp DR, Hodes GE. Sex differences in depression: An immunological perspective. Brain Res Bull 2023; 196:34-45. [PMID: 36863664 DOI: 10.1016/j.brainresbull.2023.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/05/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023]
Abstract
Depression is a heterogenous disorder with symptoms that present differently across individuals. In a subset of people depression is associated with alterations of the immune system that may contribute to disorder onset and symptomology. Women are twice as likely to develop depression and on average have a more sensitive adaptive and innate immune system when compared to men. Sex differences in pattern recognition receptors (PRRs), release of damage-associated molecular patterns (DAMPs), cell populations, and circulating cytokines play a critical role in inflammation onset. Sex differences in innate and adaptive immunity change the response of and repair to damage caused by dangerous pathogens or molecules in the body. This article reviews the evidence for sex specific immune responses that contribute to the sex differences in symptoms of depression that may account for the higher rate of depression in women.
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Affiliation(s)
- Dawson R Kropp
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Georgia E Hodes
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
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Chen F, Liu L, Wang Y, Hu K, Ma B, Chi J. Prevalence of Depression and Anxiety in Patients With Chronic Rhinosinusitis: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 168:143-153. [PMID: 35230890 DOI: 10.1177/01945998221082538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We performed a meta-analysis and estimated the prevalence of depression and anxiety and their related factors among patients with chronic rhinosinusitis (CRS). DATA SOURCES PubMed, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO, and CBM databases. REVIEW METHODS A systematic search was performed for relevant studies published before August 17, 2021. A random effects model was used to estimate the prevalence of depression and anxiety. Subgroup analysis was performed by continent or region, study setting, sex, sample size, diagnosis, and assessment method. RESULTS Twenty-two articles covering 40,956 patients were included in the meta-analysis. The pooled crude prevalence estimates of depression and anxiety were 25.2% (95% CI, 20.9%-29.6%) and 28.9% (95% CI, 16.1%-41.6%), respectively. Subgroup analyses revealed the following: (1) continent or region, study setting, sex, sample size, depression assessment method, and CRS diagnosis were significantly correlated with the prevalence of depression, and (2) continent or region, study setting, sample size, anxiety assessment method, and CRS diagnosis were significantly correlated with the prevalence of anxiety. Meta-regression analysis revealed that study setting and sample size were negatively associated with the pooled prevalence of depression. In contrast, CRS diagnosis and anxiety assessment method were positively associated with the pooled prevalence of anxiety. CONCLUSION Depression and anxiety are common in patients with CRS, especially among clinics. Therefore, in patients with CRS, screening and early diagnosis of depression and anxiety are necessary for prevention and treatment.
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Affiliation(s)
- Fei Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Libo Liu
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yetong Wang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Ke Hu
- Department of Hepatobiliary and Pancreatic Surgery, The First People's Hospital of Kunming, Kunming, China
| | - Bin Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Junting Chi
- Department of Nursing, The First People's Hospital of Yunnan Province, Kunming, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Wieczorek M, Verstappen SM, Putrik P, Gwinnutt JM, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Rodríguez-Carrio J, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda M, Guillemin F. Association of vocational interventions and work-related factors with disease and work outcomes in people with RMDs: A systematic review. Semin Arthritis Rheum 2023; 58:152135. [PMID: 36434893 DOI: 10.1016/j.semarthrit.2022.152135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/20/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE A EULAR taskforce was convened to develop recommendations for lifestyle behaviours amongst people with rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on work-related factors and disease-specific outcomes for people with osteoarthritis, rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis (SSc) and gout. METHODS Two separate systematic literature reviews (SLRs) were conducted. The first identified SLRs, published between 01/2013 and 09/2018. The second identified original observational and intervention studies published before 05/2019. Manuscripts were included if they assessed the effects of vocational interventions on disease-specific outcomes (i.e. clinical outcomes, patient-reported outcomes, and work outcomes) or if they assessed the association between work-related factors and these outcomes. Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases were searched. RESULTS Two SLRs were identified including individuals with SSc and inflammatory arthritis. Subsequently, 23 original manuscripts were identified, with most of them (43.5%) including people with RA and no manuscripts on gout. Most observational studies evaluated the association between work-related factors and work outcomes while limited information was available on the impact of work on clinical outcomes. A few studies suggested that physically demanding jobs have a small detrimental effect on radiographic progression in axSpA and PsA. Intervention studies showed beneficial effects of vocational interventions for disease-specific outcomes, but with small effect sizes. CONCLUSION Many studies indicated that work participation is not likely to be detrimental and, in some cases, may be beneficial for RMD-specific outcomes and should therefore receive attention within healthcare consultations.
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Affiliation(s)
- Maud Wieczorek
- Université de Lorraine, EA 4360 Apemac, Nancy, France; Centre on Aging and Mobility, University Hospital Zurich, City Hospital Zurich, Waid and University of Zurich, Zurich, Switzerland
| | - Suzanne Mm Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, UK
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology Department, "Sf Maria Hospital", "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich, City Hospital Zurich, Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland; University Clinic for Aging Medicine, City Hospital - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, United Kingdom
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria; Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria; Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Spain; Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Lucía Silva-Fernández
- Rheumatology Department. Hospital Universitari Son Espases. Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia; Department of Internal Medicine University of East Sarajevo Medical Faculty Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- Université de Lorraine, EA 4360 Apemac, Nancy, France; Inserm, CHRU Nancy, Université de Lorraine, CIC-1433 Epidémiologie Clinique, Nancy, France
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Ausderau KK, Colman RJ, Kabakov S, Schultz-Darken N, Emborg ME. Evaluating depression- and anxiety-like behaviors in non-human primates. Front Behav Neurosci 2023; 16:1006065. [PMID: 36744101 PMCID: PMC9892652 DOI: 10.3389/fnbeh.2022.1006065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Depression and anxiety are some of the most prevalent and debilitating mental health conditions in humans. They can present on their own or as co-morbidities with other disorders. Like humans, non-human primates (NHPs) can develop depression- and anxiety-like signs. Here, we first define human depression and anxiety, examine equivalent species-specific behaviors in NHPs, and consider models and current methods to identify and evaluate these behaviors. We also discuss knowledge gaps, as well as the importance of evaluating the co-occurrence of depression- and anxiety-like behaviors in animal models of human disease. Lastly, we consider ethical challenges in depression and anxiety research on NHPs in order to ultimately advance the understanding and the personalized treatment of these disorders.
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Affiliation(s)
- Karla K. Ausderau
- Wisconsin National Primate Research Center, University of Wisconsin—Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin—Madison, Madison, WI, United States
- Department of Kinesiology, University of Wisconsin—Madison, Madison, WI, United States
| | - Ricki J. Colman
- Wisconsin National Primate Research Center, University of Wisconsin—Madison, Madison, WI, United States
- Department of Cell and Regenerative Biology, University of Wisconsin—Madison, Madison, WI, United States
| | - Sabrina Kabakov
- Department of Kinesiology, University of Wisconsin—Madison, Madison, WI, United States
| | - Nancy Schultz-Darken
- Wisconsin National Primate Research Center, University of Wisconsin—Madison, Madison, WI, United States
| | - Marina E. Emborg
- Wisconsin National Primate Research Center, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin—Madison, Madison, WI, United States
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Emerson JS, Gruenewald SM, Gomes L, Lin MW, Swaminathan S. The conundrum of neuropsychiatric systemic lupus erythematosus: Current and novel approaches to diagnosis. Front Neurol 2023; 14:1111769. [PMID: 37025200 PMCID: PMC10070984 DOI: 10.3389/fneur.2023.1111769] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/07/2023] [Indexed: 04/08/2023] Open
Abstract
Recognising neuropsychiatric involvement by systemic lupus erythematosus (SLE) is of growing importance, however many barriers to this exist at multiple levels of our currently available diagnostic algorithms that may ultimately delay its diagnosis and subsequent treatment. The heterogeneous and non-specific clinical syndromes, serological and cerebrospinal fluid (CSF) markers and neuroimaging findings that often do not mirror disease activity, highlight important research gaps in the diagnosis of neuropsychiatric SLE (NPSLE). Formal neuropsychological assessments or the more accessible screening metrics may also help improve objective recognition of cognitive or mood disorders. Novel serum and CSF markers, including autoantibodies, cytokines and chemokines have also shown increasing utility as part of diagnosis and monitoring, as well as in distinguishing NPSLE from SLE patients without SLE-related neuropsychiatric manifestations. Novel neuroimaging studies also expand upon our existing strategy by quantifying parameters that indicate microarchitectural integrity or provide an assessment of neuronal function. Some of these novel markers have shown associations with specific neuropsychiatric syndromes, suggesting that future research move away from considering NPSLE as a single entity but rather into its individually recognized neuropsychiatric manifestations. Nevertheless, it is likely that a composite panel of these investigations will be needed to better address the gaps impeding recognition of neuropsychiatric involvement by SLE.
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Affiliation(s)
- Jonathan S. Emerson
- Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Centre for Immunology and Allergy Research, The Westmead Institute for Medical Research, Sydney, NSW, Australia
- *Correspondence: Jonathan S. Emerson,
| | - Simon M. Gruenewald
- Department of Nuclear Medicine, PET and Ultrasound, Westmead Hospital, Sydney, NSW, Australia
| | - Lavier Gomes
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Department of Radiology, Westmead Hospital, Sydney, NSW, Australia
| | - Ming-Wei Lin
- Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sanjay Swaminathan
- Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Department of Clinical Immunology, Blacktown Hospital, Sydney, NSW, Australia
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Li W, Kan H, Zhang W, Zhong Y, Liao W, Huang G, Wu P. Mendelian randomization study on the causal effects of systemic lupus erythematosus on major depressive disorder. J Hum Genet 2023; 68:11-16. [PMID: 36316471 DOI: 10.1038/s10038-022-01080-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/06/2022]
Abstract
The vast majority of epidemiological studies suggested a link between systemic lupus erythematosus (SLE) and major depressive disorder (MDD). However, the causality for SLE on the risk of MDD remained unknown due to confounding factors or reverse causality. Herein, we investigated the causality between SLE and MDD in those of European ancestry by a Mendelian randomization (MR) approach. Summary genetic data of cases with SLE/MDD were derived from independent largest public genome-wide association study. Forty-six single nucleotide polymorphisms associated with SLE were used as instrumental variables. The main causal inference was carried out using the MRE-IVW method. Additional, reverse-direction MR and multivariable MR analyses were further performed. Result indicated that SLE was causally associated with a lower risk of MDD (using the MRE-IVW method, odds ratio [OR] = 0.983, 95% confidence interval [CI] = 0.974-0.991, p = 1.18 × 10-4). Complementary analysis found no heterogeneity or horizontal pleiotropy. Multivariate MR analysis yielded consistent results (OR = 0.981; 95% CI = 0.969-0.993; p = 2.75 × 10-3). Reverse-direction MR analysis suggested non-causal relationship of MDD on the risk of SLE (using the IVW method, OR = 0.846, 95% CI = 0.345-2.072; p = 0.714). Thus, this is the first study providing evidence of potential causal links between SLE and MDD and further related research is needed.
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Affiliation(s)
- Wenchang Li
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Hoktim Kan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weizhe Zhang
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Yanlin Zhong
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Weiming Liao
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Guiwu Huang
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China. .,Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.
| | - Peihui Wu
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China. .,Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.
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40
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Wang Y, Ren Y, Hong T, Lu D, Zhang F, Cao Y, Wang X. Lipidomics Changes in a Murine Model of Neuropsychiatric Lupus. J Inflamm Res 2022; 15:6569-6580. [PMID: 36506783 PMCID: PMC9733566 DOI: 10.2147/jir.s391595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/18/2022] [Indexed: 12/11/2022] Open
Abstract
Purpose Neuropsychiatric lupus (NPSLE) is one of the important manifestations of systemic lupus erythematosus. Previous studies mainly focused on the disruption of the blood-brain barrier and the production of brain-reactive autoantibodies, However, there is no comprehensive lipidomic analysis in NPSLE. Therefore, this research evaluated the lipidomic analysis in the hippocampus and liver of NPSLE mice with mood disorders, to explore the influence of the liver-brain axis on this disease. Methods MRL/lpr mice and MRL/mpj mice were respectively used as NPSLE and control groups. Behavioral tests and systemic disease characteristics of mice were assessed at the age of 18 weeks. Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS) was used for lipid metabolite determination. Multivariate statistical analysis was used to identify lipid metabolites that were differentially expressed in two groups. Results Our results showed that 355 and 405 lipid metabolites were differentially expressed between the NPSLE and control groups in the hippocampus and liver. According to the pathway enrichment analysis, several pathways were affected, and the glycerophospholipid metabolism pathway was most relevant to the mouse's depressive behavior. Conclusion Based on UPLC-MS/MS, the results provide evidence for how the liver-brain axis affects NPSLE and improve the understanding of NPSLE pathogenesis.
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Affiliation(s)
- Yihan Wang
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yating Ren
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Tao Hong
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Dingqi Lu
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Fan Zhang
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yi Cao
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xinchang Wang
- Department of Rheumatology, The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China,Correspondence: Xinchang Wang, Department of Rheumatology, The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China, Tel +86 0571-85288249, Email
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Lee J, Singh N, Gray SL, Makris UE. Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More. ACR Open Rheumatol 2022; 4:1031-1041. [PMID: 36278868 PMCID: PMC9746667 DOI: 10.1002/acr2.11503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 12/15/2022] Open
Abstract
The world population is aging, and the rheumatology workforce must be prepared to care for medically complex older adults. We can learn from our colleagues and experts in geriatrics about how to best manage multimorbidity, polypharmacy, geriatric syndromes, and shifting priorities of older adults in the context of delivering care for rheumatic and musculoskeletal diseases (RMDs). Polypharmacy, a common occurrence in an aging population with multimorbidity, affects half of older adults with RMDs and is associated with increased risk of morbidity and mortality. In addition, potentially inappropriate medications that should be avoided under most circumstances is common in the RMD population. In recent years, deprescribing, known as the process of tapering, stopping, discontinuing, or withdrawing drugs, has been introduced as an approach to improve appropriate medication use among older adults and the outcomes that are important to them. As the rheumatology patient population ages globally, it is imperative to understand the burden of polypharmacy and the potential of deprescribing to improve medication use in older adults with RMDs. We encourage the rheumatology community to implement geriatric principles, when possible, as we move toward becoming an age-friendly health care specialty.
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Affiliation(s)
- Jiha Lee
- JUniversity of MichiganAnn Arbor
| | | | | | - Una E. Makris
- University of Texas Southwestern Medical Center and VA North Texas Health Care SystemDallas
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Warchoł-Biedermann K, Mojs E, Sikorska D, Kotyla P, Teusz G, Samborski W. Psychological Implications to the Therapy of Systemic Lupus Erythematosus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16021. [PMID: 36498095 PMCID: PMC9737561 DOI: 10.3390/ijerph192316021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/20/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Systemic lupus erythematosus (SLE) is a chronic and multi-systemic autoimmune disease, which has a deleterious impact on patients' psychological well-being. This paper aims to review the existing literature on empirical research on psychological outcomes of SLE and psychological interventions to improve well-being in SLE patients. A search of significant English language articles was conducted in PubMed, Medline, ScienceDirect, Scopus, and ResearchGate databases. Titles and abstracts were screened for the relevant terms, including "systemic lupus erythematosus", "childhood-onset systemic lupus erythematosus", "juvenile systemic lupus erythematosus", "lupus nephritis", and their respective synonyms along with "depression", "anxiety", "fatigue", "medical adherence", "health-related quality of life", "self-management" or "intervention". The articles were evaluated by independent reviewers and the lists of eligible publications were compared whilst disagreements were settled by discussion. Of the 59 publications sought for retrieval, 35 papers were shortlisted based on predefined inclusion/exclusion criteria. They were classified according to their content and the methodology applied. Research topics including "anxiety and depression in SLE" and "self-management interventions for SLE patients" were identified and are presented in this review. As the prognosis and life expectancy of SLE patients are improving, further research on the psychological outcomes of SLE and the evidence-based psychological interventions to improve patients' well-being are justified.
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Affiliation(s)
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Dorota Sikorska
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Przemysław Kotyla
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia Katowice, 40-635 Katowice, Poland
| | - Grażyna Teusz
- Faculty of Educational Studies, Adam Mickiewicz University, 61-712 Poznan, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-545 Poznan, Poland
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Jones MM, Kimble LP. Body Image, Depression Symptoms, and Health-Related Quality of Life in Black Women With Systemic Lupus Erythematosus. Nurs Womens Health 2022; 26:363-370. [PMID: 36002068 PMCID: PMC9659411 DOI: 10.1016/j.nwh.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 07/10/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To examine relationships among body image, depression symptoms, and quality of life in Black women with systemic lupus erythematosus (SLE). DESIGN Descriptive, correlational design. SETTING/SAMPLE Using social media advertising, we recruited Black women with self-reported SLE to complete a web-based survey. RESULTS The female sample (N = 43) was predominantly non-Hispanic (80%) and married (58%), with a mean age of 33.5 (SD = 6.9) years. The mean time since SLE diagnosis was 5.9 (SD = 4.0) years. The majority of respondents (51%) reported using oral steroid therapy for disease control. Mean body image and depression scores, 2.0 (SD = 0.6) and 62.4 (SD = 8.5), respectively, differed from population norms of 1.80 (SD = 0.9) and 50 (SD = 10), indicating greater body image disturbance and greater depression symptoms than reported by the general population. Greater body image disturbance was significantly associated with greater depression symptoms and poorer quality of life in the area of role disruption. CONCLUSION Depression and body image disturbance among Black women with SLE should be routinely assessed and addressed by nurses and other clinicians to help promote optimal quality of life.
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Baba O, Kisaoglu H, Bilginer C, Ozkaya E, Kalyoncu M. Depression, anxiety, and sleep quality in childhood onset systemic lupus erythematosus and relationship with brain-derived neurotrophic factor. Lupus 2022; 31:1630-1638. [DOI: 10.1177/09612033221127901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The association between brain-derived neurotrophic factor (BDNF) and systemic lupus erythematosus (SLE) is controversial, and no study investigated the clinical associations of BDNF in patients with childhood onset systemic lupus erythematosus (cSLE). In this study, we aimed to investigate the serum levels of BDNF in patients with cSLE and examine whether a relationship of BDNF exists among depression, anxiety, and sleep quality. Methods Thirty patients and age-sex matched healthy controls were included. Depression, anxiety, sleep quality and quality of life were assessed by relevant questionnaires. Disease activity was assessed according to the SLE disease activity index (SLEDAI) and serum BDNF level was measured by the enzyme-linked immunosorbent assay method. Results Serum BDNF level was significantly lower in cSLE patients than healthy controls (21981 vs 29905 pg/mL, p = 0.001) and significantly decreased level was observed in active cSLE (SLEDAI >0), then those with SLEDAI = 0 (17110 vs 26852 pg/mL, p = 0.005). Although the scores of the depression, anxiety, sleep quality and quality of life questionnaires were strongly correlated with each other, no correlation was observed with serum BDNF levels. Conclusions In patients with cSLE, serum level of BDNF was significantly decreased compared to healthy controls. Our results suggest that serum BDNF levels were not associated with the presence of anxiety, depression and poor sleep quality and might be dictated by the pathophysiological process of SLE rather than mood disorders.
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Affiliation(s)
- Ozge Baba
- Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Hakan Kisaoglu
- Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Cilem Bilginer
- Department of Child and Adolescent Psychiatry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Esra Ozkaya
- Department of Medical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Mukaddes Kalyoncu
- Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
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Chen H, Cui H, Geng Y, Jin T, Shi S, Li Y, Chen X, Shen B. Development of a nomogram prediction model for depression in patients with systemic lupus erythematosus. Front Psychol 2022; 13:951431. [PMID: 36186364 PMCID: PMC9518674 DOI: 10.3389/fpsyg.2022.951431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease with depression as one of its most common symptoms. The aim of this study is to establish a nomogram prediction model to assess the occurrence of depression in patients with SLE. Based on the Hospital Anxiety and Depression Scale cutoff of 8, 341 patients with SLE, recruited between June 2017 and December 2019, were divided into depressive and non-depressive groups. Data on socio-demographic characteristics, medical history, sociopsychological factors, and other risk factors were collected. Between-group differences in clinical characteristics were assessed with depression as the dependent variable and the variables selected by logistic multiple regression as predictors. The model was established using R language. Marital status, education, social support, coping, and anxiety predicted depression (p < 0.05). The nomogram prediction model showed that the risk rate was from 0.01 to 0.80, and the receiver operating characteristic curve analysis showed that the area under the curve was 0.891 (p < 0.001). The calibration curve can intuitively show that the probability of depression predicted by the nomogram model is consistent with the actual comparison. The designed nomogram provides a highly predictive assessment of depression in patients with SLE, facilitating more comprehensive depression evaluation in usual clinical care.
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Affiliation(s)
- Haoyang Chen
- Department of Nursing, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Nantong Second People’s Hospital, Nantong, China
| | - Hengmei Cui
- Department of Nursing, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaqin Geng
- Department of Rheumatology, The Second People’s Hospital of Changzhou, Changzhou, China
| | - Tiantian Jin
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Songsong Shi
- Department of Nursing, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunyun Li
- Department of Nursing, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Chen
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Biyu Shen
- Department of Nursing, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Biyu Shen,
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Hu Y, Zhan G. Anxiety and depression prevalence and their risk factors in lupus nephritis patients: A case–control study. Immun Inflamm Dis 2022; 10:e689. [PMID: 36039650 PMCID: PMC9394231 DOI: 10.1002/iid3.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Anxiety and depression exhibit a high prevalence in systemic lupus erythematosus (SLE) patients, while this issue is seldom explored in lupus nephritis (LN). Hence, the current study aimed to investigate the prevalence of anxiety and depression, and the risk factors for these mental disorders in LN patients. Methods Fifty LN patients, 50 non‐LN SLE patients, and 50 health control (HCs) were enrolled. The Hospital Anxiety and Depression Scale (HADS) for anxiety (HADS‐A) score and HADS for depression (HADS‐D) score were evaluated. Results HADS‐A score was highest in LN patients (median 7.0, interquartile range [IQR]: 6.0–10.0), followed by non‐LN SLE patients (median 6.0, IQR: 5.0–8.0), and lowest in HCs (median 5.0, IQR: 3.0–7.0) (p < .001). Besides, the anxiety rate was most frequent in LN patients (38.0%), followed by non‐LN SLE patients (28.0%), least common in HCs (12.0%) (p = .011). HADS‐D score was highest in LN patients (median 7.5, IQR: 6.0–11.0), followed by non‐LN SLE patients (median 6.0, IQR: 5.0–8.3), and lowest in HCs (median 4.0, IQR: 2.0–6.3) (p < .001). Similarly, the depression rate was most prevalent in LN patients (50.0%), subsequently the non‐LN SLE patients (30.0%), and rarest in HCs (10.0%) (p < .001). Furthermore, in LN patients, age (p = .009), LN activity index (p = .020), alopecia (p = .023), 24 h proteinuria (p = .044), and C‐reactive protein (p = .049) were independently correlated with higher anxiety risk; meanwhile, age (p = .001) and LN activity index (p = .009) were independently correlated with higher depression risk. Conclusion Anxiety and depression are highly prevalent, which link to aging, alopecia, inflammation, and severe renal involvement in LN patients.
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Affiliation(s)
- Ying Hu
- Department of Nephrology, the First Affiliated Hospital of Harbin Medical University Harbin China
| | - Ge Zhan
- Department of General Therapy The First Specialized Hospital of Harbin Harbin China
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Andayani S, Kumoroyekti T, Pradana K, Hamijoyo L. The association of psychosocial stressors and psychiatric disorders with fatigue in systemic lupus erythematosus patients. Lupus 2022; 31:1491-1497. [PMID: 35998900 DOI: 10.1177/09612033221122225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In systemic lupus erythematosus (SLE), fatigue is the most common and aggravating symptom which has been reported to be influenced by several factors, such as disease activity, psychosocial stressors, and psychiatric disorders. Therefore, this study aims to determine the association between disease activity, psychosocial stressors, and psychiatric disorders with fatigue in SLE patients. METHOD In this cross-sectional study, 73 female SLE patients were accepted to participate by filling out the informed consent. Besides, disease activity was divided into Lupus Low Disease Activity State (LLDAS) and non-LLDAS. The Holmes-Rahe Stress Scale and Fatigue Severity Scale (FSS) were employed to assess psychosocial stress and fatigue severity. The Mini-International Neuropsychiatric Interview (MINI) ICD-10 was used to examine psychiatric disorders. The Chi-square test was conducted to determine the association between dependent variables (fatigue) and independent variables (psychosocial stress, psychosocial stress severity, and psychiatric disorders). RESULT Out of the participants, 49 (67.1%) suffered from fatigue, and the LLDAS group contained fewer individuals than non-LLDAS, 46.6% versus 53.4%. The majority (86.3%) also experienced psychosocial stress, ranging from mild to severe, and 56 (76.7%) patients had psychiatric disorders. No significant association was discovered between SLE disease activity and fatigue. However, fatigue had significant associations with psychiatric disorders in both LLDAS (p = 0.02) and non-LLDAS groups (p = 0.04), as well as with psychosocial stress severity (p = 0.02). Histories of major personal illness (p = 0.01) and changes in eating habits (p = 0.02) were associated with fatigue among the LLDAS participants. CONCLUSION Psychosocial stressors and psychiatric disorders were significantly associated with fatigue in SLE. Histories of major personal disease and changes in eating habits were also significantly associated with fatigue in the LLDAS participants. Therefore, early recognition of these factors is necessary to manage and prevent fatigue in SLE patients.
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Affiliation(s)
- Santi Andayani
- Department of Psychiatry Hasan Sadikin General Hospital, Faculty of Medicine, 61809Padjadjaran University, Bandung, Indonesia
| | - Tri Kumoroyekti
- Department of Psychiatry Hasan Sadikin General Hospital, Faculty of Medicine, 61809Padjadjaran University, Bandung, Indonesia
| | - Kent Pradana
- Department of Psychiatry Hasan Sadikin General Hospital, Faculty of Medicine, 61809Padjadjaran University, Bandung, Indonesia
| | - Laniyati Hamijoyo
- Rheumatology Division, Department of Internal Medicine Hasan Sadikin General Hospital, Faculty of Medicine, 61809Padjadjaran University, Bandung, Indonesia.,Immunology Study Centre, Faculty of Medicine, 61809Padjadjaran University, Bandung, Indonesia
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Yang Y, Zhao R, Zhang F, Bai R, Li S, Cui R, Liu S, Xu J. Dynamic changes of amplitude of low-frequency in systemic lupus erythematosus patients with cognitive impairment. Front Neurosci 2022; 16:929383. [PMID: 36081656 PMCID: PMC9447953 DOI: 10.3389/fnins.2022.929383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cognitive dysfunction (CI) is frequently reported in patients with systemic lupus erythematosus (SLE), but the identification and assessment of SLE-related CI remain challenging. Previous studies have focused on changes in static brain activity, and no studies have investigated the characteristics of dynamic brain activity in SLE patients with CI. Objects We calculated the dynamic amplitude of low-frequency fluctuation (dALFF) by combining the ALFF with a sliding window method to assess the temporal variability of brain functional activity in SLE patients with and without CI. Methods Thirty-eight SLE with CI, thirty-eight SLE without CI, and thirty-eight healthy controls (HCs) were recruited. By comparing static ALFF (sALFF) and dALFF among the three groups, changes in brain activity intensity and its temporal variability were assessed in patients with SLE with or without CI. Spearman correlation coefficients were calculated between the brain function indicator and Mini-mental State Examination (MMSE) scores of SLE with CI. Results Subjects among the three groups exhibited significant sALFF differences in the right parahippocampal gyrus, left caudate nucleus, right putamen, and left cuneus. Compared to the SLE without CI, the right parahippocampal gyrus exhibited higher sALFF in the SLE with CI group. Compared to the HCs, the left caudate nucleus exhibited increased sALFF in the SLE with CI group. Participants in the three groups exhibited significant dALFF variability in the right parahippocampal gyrus, right lingual gyrus, and bilateral inferior occipital gyrus. Compared to the HCs, the right lingual gyrus exhibited reduced dALFF in the SLE without CI group. Compared to the HCs, the right parahippocampal gyrus exhibited increased dALFF, left calcarine fissure, and the surrounding cortex exhibited reduced dALFF in the SLE with CI group. There was no significant correlation between the MMSE score, sALFF, and dALFF in the SLE with CI group. Conclusion SLE patients with CI have abnormal brain activity intensity and stability. By analyzing the dynamics of intrinsic brain activity, it provides a new idea for evaluating SLE-related CI. However, more research and validation with multiple metrics are needed to determine the link between the severity of cognitive impairment (CI) and brain activity in patients with SLE.
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Affiliation(s)
- Yifan Yang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ruotong Zhao
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fengrui Zhang
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ru Bai
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shu Li
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ruomei Cui
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shuang Liu
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jian Xu
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China
- *Correspondence: Jian Xu,
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The Relationship between Stress, Inflammation, and Depression. Biomedicines 2022; 10:biomedicines10081929. [PMID: 36009476 PMCID: PMC9405608 DOI: 10.3390/biomedicines10081929] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 12/18/2022] Open
Abstract
A narrative review about the relationship between stress, inflammation, and depression is made as follows: Chronic stress leads to various stress-related diseases such as depression. Although most human diseases are related to stress exposure, the common pathways between stress and pathophysiological processes of different disorders are still debatable. Chronic inflammation is a crucial component of chronic diseases, including depression. Both experimental and clinical studies have demonstrated that an increase in the levels of pro-inflammatory cytokines and stress hormones, such as glucocorticoids, substantially contributes to the behavioral alterations associated with depression. Evidence suggests that inflammation plays a key role in the pathology of stress-related diseases; however, this link has not yet been completely explored. In this study, we aimed to determine the role of inflammation in stress-induced diseases and whether a common pathway for depression exists. Recent studies support pharmacological and non-pharmacological treatment approaches significantly associated with ameliorating depression-related inflammation. In addition, major depression can be associated with an activated immune system, whereas antidepressants can exert immunomodulatory effects. Moreover, non-pharmacological treatments for major depression (i.e., exercise) may be mediated by anti-inflammatory actions. This narrative review highlights the mechanisms underlying inflammation and provides new insights into the prevention and treatment of stress-related diseases, particularly depression.
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Nikoloudaki M, Repa A, Pitsigavdaki S, Molla Ismail Sali A, Sidiropoulos P, Lionis C, Bertsias G. Persistence of Depression and Anxiety despite Short-Term Disease Activity Improvement in Patients with Systemic Lupus Erythematosus: A Single-Centre, Prospective Study. J Clin Med 2022; 11:jcm11154316. [PMID: 35893407 PMCID: PMC9329785 DOI: 10.3390/jcm11154316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023] Open
Abstract
Mental disorders such as anxiety and depression are prevalent in systemic lupus erythematosus (SLE) patients, yet their association with the underlying disease activity remains uncertain and has been mostly evaluated at a cross-sectional level. To examine longitudinal trends in anxiety, depression, and lupus activity, a prospective observational study was performed on 40 adult SLE outpatients with active disease (SLE Disease Activity Index [SLEDAI]-2K ≥ 3 [excluding serology]) who received standard-of-care. Anxiety and depression were determined at baseline and 6 months by the Hospital Anxiety and Depression Scale. Treatment adherence was assessed with the Morisky Medication Adherence Scale-4. Increased anxiety (median [interquartile range] HADS-A: 11.0 [7.8]) and depression (HADS-D: 8.0 [4.8]) were found at inclusion, which remained stable and non-improving during follow-up (difference: 0.0 [4.8] and −0.5 [4.0], respectively) despite reduced SLEDAI-2K by 2.0 (4.0) (p < 0.001). Among possible baseline predictors, paid employment—but not disease activity—correlated with reduced HADS-A and HADS-D with corresponding standardized beta-coefficients of −0.35 (p = 0.017) and −0.27 (p = 0.093). Higher anxiety and depression correlated with lower treatment adherence (p = 0.041 and p = 0.088, respectively). These results indicate a high-mental disease burden in active SLE that persists despite disease control and emphasize the need to consider socioeconomic factors as part of comprehensive patient assessment.
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Affiliation(s)
- Myrto Nikoloudaki
- Department of Rheumatology and Clinical Immunology, University Hospital of Heraklion and Medical School, University of Crete, 71110 Heraklion, Greece; (M.N.); (A.R.); (S.P.); (A.M.I.S.); (P.S.)
| | - Argyro Repa
- Department of Rheumatology and Clinical Immunology, University Hospital of Heraklion and Medical School, University of Crete, 71110 Heraklion, Greece; (M.N.); (A.R.); (S.P.); (A.M.I.S.); (P.S.)
| | - Sofia Pitsigavdaki
- Department of Rheumatology and Clinical Immunology, University Hospital of Heraklion and Medical School, University of Crete, 71110 Heraklion, Greece; (M.N.); (A.R.); (S.P.); (A.M.I.S.); (P.S.)
| | - Ainour Molla Ismail Sali
- Department of Rheumatology and Clinical Immunology, University Hospital of Heraklion and Medical School, University of Crete, 71110 Heraklion, Greece; (M.N.); (A.R.); (S.P.); (A.M.I.S.); (P.S.)
| | - Prodromos Sidiropoulos
- Department of Rheumatology and Clinical Immunology, University Hospital of Heraklion and Medical School, University of Crete, 71110 Heraklion, Greece; (M.N.); (A.R.); (S.P.); (A.M.I.S.); (P.S.)
- Institute of Molecular Biology and Biotechnology—FORTH, 71110 Heraklion, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, University of Crete Medical School, 71110 Heraklion, Greece;
| | - George Bertsias
- Department of Rheumatology and Clinical Immunology, University Hospital of Heraklion and Medical School, University of Crete, 71110 Heraklion, Greece; (M.N.); (A.R.); (S.P.); (A.M.I.S.); (P.S.)
- Institute of Molecular Biology and Biotechnology—FORTH, 71110 Heraklion, Greece
- Correspondence: ; Tel.: +30-2810-394635
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