Lupus and Anxiety & Depression
By Dr. Robert Katz
Medical Advisory Board
The effects of exercise intervention on health-related quality of life in patients with systemic lupus in the journal Healthcare.
In this study, 1,058 articles were reviewed, and nine of them discussed systemic lupus and exercise. Five of them were randomized controlled trials, which is the best form of reliable research. The things that were positive were that exercise intervention compared to usual care might be able to improve the physical functioning and health-related quality of life in patients with lupus.
Sometimes exercising even five minutes a day, but doing it every day of the month, can be helpful, especially in getting patients started. Aerobic exercise may be the most valuable type, but even weight training is helpful. The objective is to improve function, energy, and sense of health and well-being. This is certainly something for lupus patients to consider. Medication for depression may be necessary.
The next study is the prevalence of depression and anxiety in systemic lupus, a review and meta-analysis from the journal BMC Psychiatry. In this study, the prevalence of depression and anxiety was found to be high in lupus patients. The article recommends that Rheumatologists should screen for depression and anxiety in their patients and refer them to mental health providers to identify effective strategies.
In this paper, 59 identified studies were reported with a total of 10,828 adult lupus patients. The prevalence of major depression and anxiety was 24% according to criteria. The prevalence of significant anxiety was approximately 40%.
It is sometimes difficult to tell the difference between frustration and true depression, and further evaluation may be necessary, but confronting depression and anxiety is important for lupus patients to undertake.
Next, in a review in Medicine (2018), a study evaluated depression and anxiety in systemic lupus. Despite suffering from pain and disability, rheumatoid arthritis patients had less anxiety and better relationship scores. The prevalence of depression in lupus in this study was six times greater than in healthy control subjects. Anxiety levels were also significantly higher in lupus patients than healthy and rheumatoid arthritis controls. The authors hypothesized that psychosocial factors such as education level and marital status were associated with depression and anxiety in lupus.
Many studies have noted the importance of social support, both familial and non-familial, with regard to depression. Authors have observed a correlation between depression scores and relationship satisfaction in the depressed patient group. Social support is a crucial environmental resource necessary for mental health. Depressive characteristics are associated with a decrease in peer-related social support. Familial social support is important for mental health, and a decrease in relationship satisfaction is an indicator of depression.
Sleep quality of lupus patients, while not that good, did not appear to contribute directly to depression, and the treatment of fatigue remains an obstacle for patients to surmount.
Levels of a chemical substance in the body called interleukin-10 were found to be an indicator of depression in lupus patients, but fatigue and relationship satisfaction were the best predictors of depression.
Robert S. Katz, M.D.
October 19, 2021