Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jun 19, 2024; 14(6): 829-837
Published online Jun 19, 2024. doi: 10.5498/wjp.v14.i6.829
Analysis of status and influencing factors of mental health in patients with systemic lupus erythematosus
Xuan Zhang, Zhe Wang, Gui-Ling Lin, Fang-Zhi Wei, Yan-Ping Zhuang, Wen-Lu Xu, Qi Zhang, Hui-Tao Wu, Zi-Man He, Xi-Yu Yin, Ying Liu, Long Mi, Ai-Min Gong
Xuan Zhang, Zhe Wang, Gui-Ling Lin, Fang-Zhi Wei, Yan-Ping Zhuang, Wen-Lu Xu, Qi Zhang, Hui-Tao Wu, Zi-Man He, Xi-Yu Yin, Ai-Min Gong, School of Traditional Chinese Medicine, Hainan Medical University, Haikou 571101, Hainan Province, China
Ying Liu, Department of Rheumatology and Immunology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Long Mi, Department of Radiology, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou 570100, Hainan Province, China
Co-first authors: Xuan Zhang and Zhe Wang.
Co-corresponding authors: Long Mi and Ai-Min Gong.
Author contributions: Zhang X, Wang Z, Mi L and Gong AM designed the research; Zhang X, Wang Z, Lin GL, Wei FZ screened patients, acquired clinical data; Zhuang YP, Xu WL, Zhang Q, Wu HT, He ZM, Yin XY, Liu Y, Mi L and Gong AM collected questionnaires and performed individual interviews; Zhang X, Wang Z, Mi L and Gong AM conducted the analysis and provided guidance for the research; Zhang X, Wang Z, Mi L and Gong AM performed data analysis and prepared the first draft of the manuscript. Zhang X proposed, designed the research, performed data analysis and prepared the first draft of the manuscript. Wang Z was responsible for patient screening, enrollment, collection of clinical data. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. All authors reviewed and approved the final manuscript. Zhang X and Wang Z contributed equally to this work and are co-first authors. Both Mi L and Gong AM have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Mi L applied for and obtained the funds for this research project. Mi L conceptualized, designed, and supervised the whole process of the project. Mi L searched the literature, revised and submitted the early version of the manuscript. Gong AM was instrumental and responsible for data re-analysis and re-interpretation, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Mi L and Gong AM is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported by National Natural Science Foundation of China, No. 81760840 and No. 82160874; and Natural Science Foundation of Hainan Province, No. 2019RC206.
Institutional review board statement: This study was approved by the Ethic Committee of Hainan Medical University (Approval No. HYLL-2023-455).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: The data used in the above analysis are available upon reasonable request from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ai-Min Gong, MD, Doctor, School of Traditional Chinese Medicine, Hainan Medical University, No. 3 Xueyuan Road, Haikou 571101, Hainan Province, China. gongaimin2021@126.com
Received: February 26, 2024
Revised: April 23, 2024
Accepted: May 6, 2024
Published online: June 19, 2024
Processing time: 114 Days and 11.5 Hours
Abstract
BACKGROUND

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder with varied clinical courses and prognoses, not only did the patients suffer from physical impairment, but also various physical and psychiatric comorbidities. Growing evidence have suggested that mental disorders in SLE patients, can lead to various adverse consequences.

AIM

To explored the features and influencing factors of mental health in patients with SLE and clarifying the correlations between mental health and personality characteristics and perceived social support. The results would provide a basis for psychological intervention in patients with SLE.

METHODS

The clinical data of 168 patients with SLE admitted at the First Affiliated Hospital of Hainan Medical University between June 2020 and June 2022 were collected. Psychological assessment and correlation analysis were conducted using the Symptom Checklist-90 (SCL-90) and Perceived Social Support Scale, and the collected data were compared with the national norms in China. The relevant factors influencing mental health were identified by statistical analysis. A general information questionnaire, the Revised Life Orientation Test, and Short-Form 36-Item Health Survey were employed to assess optimism level and quality of life (QoL), respectively.

RESULTS

Patients with SLE obtained higher scores for the somatization, depression, anxiety, and phobic anxiety subscales than national norms (P < 0.05). A correlation was identified between total social support and total SCL-90 score or each subscale (P < 0.05). The factors significantly affecting patients’ mental health were hormone dosage and disease activity index (DAI) (P < 0.05). The average optimism score of patients with SLE was 14.36 ± 4.42, and 30 cases were in the middle and lower levels. A positive correlation was found between optimism level and QoL scores.

CONCLUSION

Patients with SLE develop psychological disorders at varying degrees, which are significantly influenced by hormone dosage and DAI. Patients’ mental health should be closely monitored during clinical diagnosis and treatment and provided adequate support in establishing positive, healthy thinking and behavior patterns and improving their optimism level and QoL.

Keywords: Systemic lupus erythematosus; Mental health; Quality of life; Influencing factors

Core Tip: Patients with systemic lupus erythematosus suffer from various physical and psychiatric comorbidities. These serious forms of the disease can significantly impair activities of daily living and social roles. The identification of the factors that trigger these complications enables the causes to be determined and measures to be implemented to improve patient health.