Methods: This was a cross-sectional exploratory study in 378 patients diagnosed with SLE and receiving services from the SLE Lupus Foundation in New York City. In addition to socio-demographic variables, the instrument used consisted of two scales, the Systemic Lupus Erythematosus Needs Questionnaire (SLENQ) and the Multidimensional Health Locus of Control Scale, as well as questions regarding subjective perceptions of side effects from SLE medication.
Results: The highest general causes of self-reported depressive and anxious feelings were changes in appearance due to SLE, and limitations in physical abilities due to SLE (primarily from muscle [t = 6.2 p <.001] and joint pain [t = 5.4 p < .001]). The higher the sense of control over SLE, the less likely respondents were to report feeling depressed and anxious. African-American and Hispanic SLE patients reported statistically significantly higher levels of unmet psychological needs due to SLE than did their other ethnic counterparts (f = 3.9 p <.01). Weight gain and hair loss were the most likely medication side effects and also the most likely causes of SLE-related depression (t = 4.1 p <.001) and anxiety (t = 4.2 p <.001).
Conclusion: Those living with SLE are at risk for feelings of depression and anxiety. African-American and Hispanic women are at higher risk for these emotional states. Comprehensive assessment across the disciplines should screen this group of patients for depression and anxiety, and be prepared to refer them to patient education and social work counseling as indicated. Identifying that feelings of depression and anxiety occur at significant rates for those living with SLE (due primarily to changes in body appearance and limitations in functional abilities) is critical. However, depression and anxiety are broad terms that can reflect very different levels of acuity and frequency for each patient. A recommendation for assessment care as well a future research would be to include the SLENQ as a comprehensive assessment tool alongside other mental health inventories such as the Beck Depression scale to further refine the diagnosis with clientele and to provide more precision in data for research. Future research should study SLE patients to gain further information about how they do cope and what strengths (internal and external) aid in the resilience of patients coping with this chronic disease.
