Anxiety and depression prevalence and their risk factors in lupus nephritis patients: A case-control study

Abstract

Introduction: Anxiety and depression exhibit a high prevalence in systemic lupus erythematosus (SLE) patients, while this issue is seldom explored in lupus nephritis (LN). Hence, the current study aimed to investigate the prevalence of anxiety and depression, and the risk factors for these mental disorders in LN patients.

Methods: Fifty LN patients, 50 non-LN SLE patients, and 50 health control (HCs) were enrolled. The Hospital Anxiety and Depression Scale (HADS) for anxiety (HADS-A) score and HADS for depression (HADS-D) score were evaluated.

Results: HADS-A score was highest in LN patients (median 7.0, interquartile range [IQR]: 6.0-10.0), followed by non-LN SLE patients (median 6.0, IQR: 5.0-8.0), and lowest in HCs (median 5.0, IQR: 3.0-7.0) (p < .001). Besides, the anxiety rate was most frequent in LN patients (38.0%), followed by non-LN SLE patients (28.0%), least common in HCs (12.0%) (p = .011). HADS-D score was highest in LN patients (median 7.5, IQR: 6.0-11.0), followed by non-LN SLE patients (median 6.0, IQR: 5.0-8.3), and lowest in HCs (median 4.0, IQR: 2.0-6.3) (p < .001). Similarly, the depression rate was most prevalent in LN patients (50.0%), subsequently the non-LN SLE patients (30.0%), and rarest in HCs (10.0%) (p < .001). Furthermore, in LN patients, age (p = .009), LN activity index (p = .020), alopecia (p = .023), 24 h proteinuria (p = .044), and C-reactive protein (p = .049) were independently correlated with higher anxiety risk; meanwhile, age (p = .001) and LN activity index (p = .009) were independently correlated with higher depression risk.

Conclusion: Anxiety and depression are highly prevalent, which link to aging, alopecia, inflammation, and severe renal involvement in LN patients.

Keywords: anxiety; depression; lupus nephritis; prevalence; risk factors.

Figure 1

Comparison of anxiety status among HCs, non‐LN SLE, and LN patients. Comparison of HADS‐A score (A) and anxiety rate (B) among HCs, non‐LN SLE, and LN patients. HADS, Hospital Anxiety and Depression Scale; HCs, health controls; LN, lupus nephritis; SLE, systemic lupus erythematosus disease

Figure 2

Comparison of depression status among HCs, non‐LN SLE, and LN patients. Comparison of HADS‐D score (A) and depression rate (B) among HCs, non‐LN SLE, and LN patients. HADS, Hospital Anxiety and Depression Scale; HCs, health controls; LN, lupus nephritis; SLE, systemic lupus erythematosus disease