Association of disease activity with depression and anxiety in systemic lupus erythematosus: a comparison of SLEDAI-2K and SLE-DAS

Abstract

Abstract Objective To explore the association of disease activity, as evaluated by both the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) and the SLEDAI-2000 (SLEDAI-2K), with depression and anxiety in patients with SLE. Methods A cross-sectional study was conducted among 85 Chinese patients with SLE. Disease activity was measured using SLEDAI-2K and SLE-DAS scoring systems. Depression and anxiety were assessed using Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7, respectively. Multivariate logistic regression analysis was performed to evaluate the association of disease activity scores, as well as specific clinical and laboratory items, with depression and anxiety. Results There was a robust correlation between SLEDAI-2K and SLE-DAS scores in overall patient population (Spearman’s r = 0.764, 95% CI 0.655–0.842; P < 0.001) and in those with moderate-to-high disease activity (Spearman’s r = 0.792, 95% CI 0.616–0.892; P < 0.0001). However, the correlation weakened for patients with mild disease activity or remission (Spearman’s r = 0.450, 95%CI 0.188–0.652; P = 0.001). Multivariate logistic regression analysis did not show a significant correlation between SLEDAI-2K and SLE-DAS scores and depression/anxiety. The presence of mucosal ulcer/serositis significantly increased the risk of depression (odds ratio = 4.472, 95% CI 1.035–19.328; P = 0.045) and anxiety (odds ratio = 3.978, 95% CI 1.051–15.049; P = 0.042). Conclusion The SLE-DAS scoring system demonstrated a comparable ability to assess disease activity in SLE compared with SLEDAI-2K. Though neither scoring system showed significant associations with depression and anxiety, the presence of mucosal ulcer/serositis markedly heightened the risk of both among SLE patients.