Major depression and disease activity among systemic lupus erythematosus Egyptian females

Aim of the workThe aim of this study was to identify the relationship between disease activity in SLE Egyptian females and the presence, severity and pattern of major depression in these patients.Patients and methodsThe study sample included 100 female patients; fifty SLE patients and fifty healthy adults with matching age serving as control. Patients were assessed using Beck Inventory Score for the presence of major depression, SLEDAI to determine disease activity, SLICC/ACR damage index and HAQ score for functional disability.ResultsThe majority of patients had symptoms of major depression 32/50 (64%) based on Beck Inventory Score while in controls only 16/50 (36%) had major depression. The most common depressive symptoms in SLE patients were: Guilty feeling (92%), Self-dislike (91.6%), Self-criticalness (90.4%), Crying spells (87.5%), Loss of pleasure (83.3%), Change in appetite (83.3%), Agitation (82.8%) and Pessimism (82%). Patients with major depression presented a trend toward having greater severity of SLE disease activity compared with those without major depression (p = 0.04). The presence of major depression was significantly associated with functional disability measured by HAQ score (p = 0.01). The patients with major depression did not differ significantly from patients without major depression regarding their steroid dosage (p = 0.55), SLICC/ACR damage score (p = 0.16) and disease duration (p = 0.69) but differed significantly as regards Beck Hopelessness Scale (p < 0.0001) and suicidal ideation score (p = 0.009).ConclusionMajor depression was highly presented in Egyptian SLE patients (64%); its severity was associated with disease activity, but not with steroid administration, cumulative damage or disease duration.