AB1224 MAJOR DEPRESSIVE DISORDER AMONG CYPRIOT PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND CORRELATION WITH CLINICAL CHARACTERISTICS AND DISEASE-SPECIFIC HEALTH-RELATED QUALITY OF LIFE
Authors: K. Parperis, S. Psarelis, S. Symeonidou, M. Michaelides, D. Nikiforou, E. Antoniade, B. Bhattarai
Journal: Annals of the Rheumatic Diseases (2020)

Background: Major depressive disorder (MDD) is a common comorbidity in patients with chronic rheumatic conditions, and patients with systemic lupus erythematous (SLE) have an increased risk of developing depression. The coexistence of SLE and MDD might lead to impaired health-related quality of life (HRQOL). Gaining a deeper understanding of the factors associated with MDD in SLE will allow us to develop strategies in order to prevent depression and achieve an early diagnosis and management. Objectives: The aim of this study is to determine the contributing factors associated with MDD in Cypriot SLE patients and examine the correlation between disease-specific HRQOL domains and depression. Methods: We conducted a cross-sectional study of SLE patients who fulfilled the SLICC-2012 criteria. The patients were recruited from August 2019 to January 2020. Baseline demographic data, clinical features, and therapeutic regimens were captured. Depression was assessed by the patient health questionnaire (PHQ)-9, a validated tool to screen and diagnosed the condition. Scores above ≥10 are indicating MDD. HRQOL was evaluated by a disease-specific validated questionnaire, LupusQoL-Greek. LupusQol scores ranged between 0-100, with higher scores reflecting better QoL. The self-rated health status was examined, and the response was separate to poor/fair vs excellent/good. Demographic data, LupusQoL domains, clinical and other features of the SLE patients were described and compared between MDD (PHQ-9 ≥ 10) and non-MDD (PHQ-9&lt;10) groups using Wilcoxon ranksum tests for continuous variables and chi-square tests for categorical variables. Results: A total of 88 SLE patients were included in the study, with a mean age of 48.6 (19-80), 71(80%) were women, and mean disease duration of 13.2 years (0-44). Compared to the non-MDD group, patients with MDD (n=32, 36%) were significantly older (mean age 53.5 vs 46.9; p=0.03) and more likely to have the following SLE manifestations: mucocutaneous, vascular, pulmonary and musculoskeletal involvement. Furthermore, patients with MDD were less likely to be clinical quiescent (34.3%) compared with the non-MDD group (57.1%) (P&lt;0.05). Self-rated health described as poor/fair was markedly associated with MDD (p&lt;0.001). The LupusQoL domains’ scores were notably lower in patients with MDD (PHQ ≥ 10), with a statistically significant reduction in all LupusQoL domains, indicating that depression was associated with worse HRQOL (Table 1). Table 1. Differences in 8 LupusQoL domain scores among SLE patients with and without major MDD (PHQ-9 .10) LupusQoL Domains (0-100) PHQ-9 &lt;10 (non-MDD) PHQ-9 ≥10 (MDD) P-value Physical Health 72.87 (81.2, 9.3-100) 40.01 (32.75, 0-90.6) &lt;0.0001 Pain 75.27 (75, 16.6-100) 43.2 (41.6, 0-100) &lt;0.0001 Planning 81.08 (91.6, 0-100) 44.51 (50, 0-100) &lt;0.0001 Intimate relationship 68.38 (75, 0-100) 46.25 (50, 0-100) 0.0382 Burden to others 79.73 (83.3, 16-100) 51.97 (50, 0-100) 0.0003 Emotional health 81.76 (85.4, 25-100) 50.14 (50, 0-91.6) &lt;0.0001 Body image 84.09 (90.8, 5-100) 58.45 (66.6, 0-100) 0.0004 Fatigue 72.08 (75, 18.7-100) 41.2 (40.6, 6.2-81.2) &lt;0.0001 Conclusion: To our knowledge, this is the first study demonstrating significantly lower scores among MDD relative non-MDD (based on PHQ-9) patients across all the 8 domains of LupusQoL; therefore, it adds to the current evidence that depression significantly impacts the quality of life of SLE. Predictors of MDD include older age, and involvement of the vascular, mucocutaneous, pulmonary, and musculoskeletal system. Additionally,a poor or fair description of self-rated health was a predictor of depression. Disclosure of Interests: None declared