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Anxiety and Mood Disorders in Systemic Lupus Erythematosus: Current Insights and Future Directions

  • Health Economics and Quality of Life (N Tsao, Section Editor)
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Abstract

Purpose of Review

Optimal management of anxiety and mood disorders in patients with systemic lupus erythematosus (SLE) is limited by an incomplete understanding of their pathophysiology and a lack of treatment guidelines. This review aims to critically synthesize recent literature on these conditions in adults with SLE, focusing on their etiology, assessment, and management.

Recent Findings

Along with psychosocial factors, there is growing evidence for a bidirectional interaction between inflammatory pathways and SLE-associated anxiety and mood disorders. Direct immune-mediated mechanisms via autoantibodies may also play a role in some cases. With a growing number of tools used in SLE for the assessment of these conditions, the search continues for the ideal instrument to use in all future investigations to allow comparisons across studies. There is data supporting psychological interventions, but a dearth of literature on pharmacotherapy for the treatment of anxiety and mood disorders in SLE.

Summary

There is a clear need for further research in anxiety and mood disorders in SLE, particularly with respect to diagnostic tools and medications, which could inform much-needed updates to current guidelines.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bengtsson AA, Ronnblom L. Systemic lupus erythematosus: still a challenge for physicians. J Intern Med. 2017;281(1):52–64. https://doi.org/10.1111/joim.12529.

    Article  CAS  PubMed  Google Scholar 

  2. Clark EC, Bailey AA. Neurological and psychiatric signs associated with systemic lupus erythematosus. J Am Med Assoc. 1956;160(6):455–7. https://doi.org/10.1001/jama.1956.02960410031007.

    Article  CAS  PubMed  Google Scholar 

  3. Liang MCM, Bae S. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599–608. https://doi.org/10.1002/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F.

    Article  Google Scholar 

  4. Kivity S, Agmon-Levin N, Zandman-Goddard G, Chapman J, Shoenfeld Y. Neuropsychiatric lupus: a mosaic of clinical presentations. BMC Med. 2015;13(1):43. https://doi.org/10.1186/s12916-015-0269-8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Govoni M, Bortoluzzi A, Padovan M, Silvagni E, Borrelli M, Donelli F, et al. The diagnosis and clinical management of the neuropsychiatric manifestations of lupus. J Autoimmun. 2016;74:41–72. https://doi.org/10.1016/j.jaut.2016.06.013.

    Article  CAS  PubMed  Google Scholar 

  6. •• Hanly JG, Su L, Urowitz MB, Romero-Diaz J, Gordon C, Bae S-CC, et al. Mood disorders in systemic lupus erythematosus: results from an international inception cohort study. Arthritis Rheumatol. 2015;67(7):1837–47. https://doi.org/10.1002/art.39111 One of the largest prospective inception cohort of SLE patients in whom anxiety and depressive disorders was systmatically evaluated and reported, and one of the few to assess attribution of mood disorder.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Uguz F, Kucuk A, Cicek E, Kayhan F, Tunc R. Mood, anxiety and personality disorders in patients with systemic lupus erythematosus. Compr Psychiatry. 2013;54(4):341–5. https://doi.org/10.1016/j.comppsych.2012.10.003.

    Article  PubMed  Google Scholar 

  8. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33 quiz 4–57.

    Google Scholar 

  9. Julian LJ, Gregorich SE, Tonner C, Yazdany J, Trupin L, Criswell LA, et al. Using the center for epidemiologic studies depression scale to screen for depression in systemic lupus erythematosus. Arthritis Care Res. 2011;63(6):884–90. https://doi.org/10.1002/acr.20447.

    Article  Google Scholar 

  10. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S467–72. https://doi.org/10.1002/acr.20561.

    Article  Google Scholar 

  11. Smarr KL, Keefer AL. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S454–66. https://doi.org/10.1002/acr.20556.

    Article  Google Scholar 

  12. • Zhang L, Fu T, Yin R, Zhang Q, Shen B. Prevalence of depression and anxiety in systemic lupus erythematosus: a systematic review and meta-analysis. BMC Psychiatry. 2017;17:70. https://doi.org/10.1186/s12888-017-1234-1 A landmark systematic review of prevalence of anxiety and depression in SLE, along with diagnostic and screening tools for these conditions.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bai R, Liu S, Zhao Y, Cheng Y, Li S, Lai A, et al. Depressive and anxiety disorders in systemic lupus erythematosus patients without major neuropsychiatric manifestations. J Immunol Res. 2016;2016:2829018.

    Article  Google Scholar 

  14. Kasturi S, Szymonifka J, Burket JC, Berman JR, Kirou KA, Levine AB, et al. Validity and reliability of patient reported outcomes measurement information system computerized adaptive tests in systemic lupus erythematosus. J Rheumatol. 2017;44(7):1024–31. https://doi.org/10.3899/jrheum.161202.

    Article  PubMed  Google Scholar 

  15. Katz P, Pedro S, Michaud K. Performance of the patient-reported outcomes measurement information system 29-item profile in rheumatoid arthritis, osteoarthritis, fibromyalgia, and systemic lupus erythematosus. Arthritis Care Res. 2017;69(9):1312–21. https://doi.org/10.1002/acr.23183.

    Article  Google Scholar 

  16. de Almeida Macêdo E, Appenzeller S, Lavras Costallat LT. Assessment of the hospital anxiety and depression scale (HADS) performance for the diagnosis of anxiety in patients with systemic lupus erythematosus. Rheumatol Int. 2017;37(12):1999–2004. https://doi.org/10.1007/s00296-017-3819-x.

    Article  PubMed  Google Scholar 

  17. Palagini L, Tani C, Bruno RM, Gemignani A, Mauri M, Bombardieri S, et al. Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms? Lupus. 2014;23(13):1350–7. https://doi.org/10.1177/0961203314540762.

    Article  CAS  PubMed  Google Scholar 

  18. Macêdo EA, Appenzeller S, Costallat LTL. Depression in systemic lupus erythematosus: gender differences in the performance of the Beck Depression Inventory (BDI), Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiety and Depression Scale (HADS). Lupus. 2018;27(2):179–89. https://doi.org/10.1177/0961203317713142.

    Article  PubMed  Google Scholar 

  19. Mahieu M, Yount S, Ramsey-Goldman R. Patient-reported outcomes in systemic lupus erythematosus. Rheum Dis Clin N Am. 2016;42(2):253–63. https://doi.org/10.1016/j.rdc.2016.01.001.

    Article  Google Scholar 

  20. Alai ZP, Hitchon C, Tisseverasinghe A. Measurement properties of mood and anxiety assessment tools in systemic lupus erythematosus: a systematic review. J Rheumatol. 2018;45(7):986–1069. https://doi.org/10.3899/jrheum.180300.

    Article  Google Scholar 

  21. Thombs BD, Kwakkenbos L, Levis AW, Benedetti A. Addressing overestimation of the prevalence of depression based on self-report screening questionnaires. Can Med Assoc J. 2018;190(2):E44–E9. https://doi.org/10.1503/cmaj.170691.

    Article  Google Scholar 

  22. Davison TE, McCabe MP, Mellor D. An examination of the “gold standard” diagnosis of major depression in aged-care settings. Am J Geriatr Psychiatry. 2009;17(5):359–67. https://doi.org/10.1097/JGP.0b013e318190b901.

    Article  PubMed  Google Scholar 

  23. Ainiala H, Loukkola J, Peltola J, Korpela M, Hietaharju A. The prevalence of neuropsychiatric syndromes in systemic lupus erythematosus. Neurology. 2001;57(3):496–500.

    Article  CAS  Google Scholar 

  24. Hanly JG, Urowitz MB, Sanchez-Guerrero J, Bae SC, Gordon C, Wallace DJ, et al. Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: an international inception cohort study. Arthritis Rheum. 2007;56(1):265–73.

    Article  CAS  Google Scholar 

  25. Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2013;52(12):2136–48. https://doi.org/10.1093/rheumatology/ket169.

    Article  Google Scholar 

  26. Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep. 2018;8(1):2861. https://doi.org/10.1038/s41598-018-21243-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Hanly JG, Fisk JD, McCurdy G, Fougere L, Douglas J-AA. Neuropsychiatric syndromes in patients with systemic lupus erythematosus and rheumatoid arthritis. J Rheumatol. 2005;32(8):1459–6.

    PubMed  Google Scholar 

  28. Marrie RA, Hitchon CA, Walld R, Patten SB, Bolton JM, Sareen J, et al. Increased burden of psychiatric disorders in rheumatoid arthritis. Arthritis Care Res. 2018;70(7):970–8. https://doi.org/10.1002/acr.23539.

    Article  Google Scholar 

  29. • Mccormick N, Trupin L, Yelin EH, Katz PP. Socioeconomic predictors of incident depression in systemic lupus erythematosus. Arthritis Care Res. 2018;70(1):104–13. https://doi.org/10.1002/acr.23247 A unique study in a large longitudinal cohort of females derived the Lupus Outcomes Study evaluating various socioeconomic risk factors for incident depression, including financial strain.

    Article  Google Scholar 

  30. •• Marrie RA, Walld R, Bolton JM, Sareen J, Walker JR, Patten SB et al. Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease. Epidemiol Psychiatr Sci. 2017:1–10. https://doi.org/10.1017/S2045796017000579. A landmark study looking at the incidence of psychiatric diagnoses, including anxiety and depression, preceding diagnosis of RA, MS, and IBD, and compared with the general population.

  31. Ramasubbu R, Taylor VH, Samaan Z, Sockalingham S, Li M, Patten S, et al. The Canadian network for mood and anxiety treatments (CANMAT) task force recommendations for the management of patients with mood disorders and select comorbid medical conditions. Ann Clin Psychiatry. 2012;24(1):91–109.

    PubMed  Google Scholar 

  32. Utset TO, Chohan S, Booth SA, Laughlin JC, Kocherginsky M, Schmitz A. Correlates of formal work disability in an urban university systemic lupus erythematosus practice. J Rheumatol. 2008;35(6):1046–52.

    PubMed  Google Scholar 

  33. Utset TO, Baskaran A, Segal BM, Trupin L, Ogale S, Herberich E, et al. Work disability, lost productivity and associated risk factors in patients diagnosed with systemic lupus erythematosus. Lupus Sci Med. 2015;2(1):e000058. https://doi.org/10.1136/lupus-2014-000058.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Petri M, Naqibuddin M, Carson KA, Wallace DJ, Weian MH, Holliday SL, et al. Depression and cognitive impairment in newly diagnosed systemic lupus erythematosus. J Rheumatol. 2010;37(10):2032–8. https://doi.org/10.3899/jrheum.091366.

    Article  PubMed  Google Scholar 

  35. Kasitanon N, Achsavalertsak U, Maneeton B, Wangkaew S, Puntana S, Sukitawut W, et al. Associated factors and psychotherapy on sleep disturbances in systemic lupus erythematosus. Lupus. 2013;22(13):1353–60. https://doi.org/10.1177/0961203313507355.

    Article  CAS  PubMed  Google Scholar 

  36. Vina ER, Green SL, Trivedi T, Kwoh KC, Utset TO. Correlates of sleep abnormalities in lupus: a cross-sectional survey in an urban, academic center. J Clin Rheumatol. 2015;19(1):7–13. https://doi.org/10.1097/RHU.0b013e31827cd20d.

    Article  Google Scholar 

  37. Mirbagher L, Gholamrezaei A, Hosseini N, Sayed Bonakdar Z. Sleep quality in women with systemic lupus erythematosus: contributing factors and effects on health-related quality of life. Int J Rheum Dis. 2016;19(3):305–11. https://doi.org/10.1111/1756-185X.12418.

    Article  PubMed  Google Scholar 

  38. Lee J-W, Kang J-H, Lee K-E, Park D-J, Kang SW, Kwok S-K, et al. Effects of risk factors for and components of metabolic syndrome on the quality of life of patients with systemic lupus erythematosus: a structural equation modeling approach. Qual Life Res. 2018;27(1):105–13. https://doi.org/10.1007/s11136-017-1689-z.

    Article  PubMed  Google Scholar 

  39. Mok CC, Chan KL, Ho LY. Association of depressive/anxiety symptoms with quality of life and work ability in patients with systemic lupus erythematosus. Clin Exp Rheumatol. 2016;34(3):389–95.

    PubMed  Google Scholar 

  40. Nowicka-Sauer K, Hajduk A, Kujawska-Danecka H, Banaszkiewicz D, Smoleńska Ż, Czuszyńska Z, et al. Illness perception is significantly determined by depression and anxiety in systemic lupus erythematosus. Lupus. 2018;27(3):454–60. https://doi.org/10.1177/0961203317751858.

    Article  CAS  PubMed  Google Scholar 

  41. Rathi S ZA, Goh KS, Caricchio R, Freid L. Impact of depression on SLE flares [abstract]. Arthritis Rheumatol. 2016;68(suppl 10).

  42. Mehat P, Atiquzzaman M, Esdaile JM, AviNa-Zubieta A, De Vera MA. Medication nonadherence in systemic lupus erythematosus: a systematic review. Arthritis Care Res. 2017;69(11):1706–13. https://doi.org/10.1002/acr.23191.

    Article  Google Scholar 

  43. Alsowaida N, Alrasheed M, Mayet A, Alsuwaida A, Omair MA. Medication adherence, depression and disease activity among patients with systemic lupus erythematosus. Lupus. 2018;27(2):327–32. https://doi.org/10.1177/0961203317725585.

    Article  CAS  PubMed  Google Scholar 

  44. Flower C, Hambleton I, Campbell M. The effect of psychosocial and neuropsychiatric factors on medication adherence in a cohort of women with systemic lupus erythematosus. J Clin Rheumatol. 2016;22(8):411–7.

    Article  Google Scholar 

  45. Julian LJ, Yelin E, Yazdany J, Panopalis P, Trupin L, Criswell LA, et al. Depression, medication adherence, and service utilization in systemic lupus erythematosus. Arthritis Rheum. 2009;61(2):240–6. https://doi.org/10.1002/art.24236.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Fors Nieves CE, Izmirly PM. Mortality in systemic lupus erythematosus: an updated review. Curr Rheumatol Rep. 2016;18(4):21. https://doi.org/10.1007/s11926-016-0571-2.

    Article  PubMed  Google Scholar 

  47. Carney RM, Freedland KE. Depression and coronary heart disease. Nat Rev Cardiol. 2017;14(3):145–55. https://doi.org/10.1038/nrcardio.2016.181.

    Article  PubMed  Google Scholar 

  48. Jorge A, Lertratanakul A, Lee J, Pearce W, McPherson D, Thompson T, et al. Depression and progression of subclinical cardiovascular disease in systemic lupus erythematosus. Arthritis Care Res. 2017;69(1):5–11. https://doi.org/10.1002/acr.22992.

    Article  Google Scholar 

  49. Greco CM, Li T, Sattar A, Kao AH, Danchenko N, Edmundowicz D, et al. Association between depression and vascular disease in systemic lupus erythematosus. J Rheumatol. 2011;39(2):262–8. https://doi.org/10.3899/jrheum.110327.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Pruett SB. Stress and the immune system. Pathophysiology. 2003;9:133–53.

    Article  CAS  Google Scholar 

  51. Jung J-Y, Nam J-Y, Kim H-A, Suh C-H. Elevated salivary alpha-amylase level, association between depression and disease activity, and stress as a predictor of disease flare in systemic lupus erythematosus: a prospective case–control study. Medicine. 2015;94(30). https://doi.org/10.1097/MD.0000000000001184.

  52. Postal M, Lapa AT, Sinicato NA, de Oliveira PK, Peres FA, Costallat LT, et al. Depressive symptoms are associated with tumor necrosis factor alpha in systemic lupus erythematosus. J Neuroinflammation. 2016;13:5. https://doi.org/10.1186/s12974-015-0471-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. • Roberts AL, Malspeis S, Kubzansky LD, Feldman CH, Chang SC, Koenen KC, et al. Association of trauma and posttraumatic stress disorder with incident systemic lupus erythematosus in a longitudinal cohort of women. Arthritis Rheumatol. 2017;69(11):2162–9. https://doi.org/10.1002/art.40222 A landmark investigation in a civilian population derived from Nurses’ Health Study cohort evaluating the association between SLE onset and prior trauma and PTSD, while accounting for life-style factors such as smoking that could contribute to SLE.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. O'Donovan A, Cohen BE, Seal KH, Bertenthal D, Margaretten M, Nishimi K, et al. Elevated risk for autoimmune disorders in iraq and afghanistan veterans with posttraumatic stress disorder. Biol Psychiatry. 2015;77(4):365–74. https://doi.org/10.1016/j.biopsych.2014.06.015.

    Article  PubMed  Google Scholar 

  55. DeQuattro K, Trupin L, Katz PP, Lanata C, Yelin EH, Criswell LA, et al. Cumulative adverse childhood experiences are associated with poor outcomes in adults with systemic lupus erythematosus. Ann Rheum Dis. 2017;76(Suppl 2):432.

    Google Scholar 

  56. Huang H, Yan P, Shan Z, Chen S, Li M, Luo C, et al. Adverse childhood experiences and risk of type 2 diabetes: a systematic review and meta-analysis. Metabolism. 2015;64(11):1408–18. https://doi.org/10.1016/j.metabol.2015.08.019.

    Article  CAS  PubMed  Google Scholar 

  57. Morand EF. Stress and the onset of SLE. Nat Rev Rheumatol. 2018;14:127–8. https://doi.org/10.1038/nrrheum.2018.2.

    Article  PubMed  Google Scholar 

  58. Tosevski DL, Milovancevic MP. Stressful life events and physical health. Curr Opin Psychiatry. 2006;19(2):184–9. https://doi.org/10.1097/01.yco.0000214346.44625.57.

    Article  PubMed  Google Scholar 

  59. Danese A, Moffitt TE, Harrington H, Milne BJ, Polanczyk G, Pariante CM, et al. Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Arch Pediatr Adolesc Med. 2009;163(12):1135–43. https://doi.org/10.1001/archpediatrics.2009.214.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Kiecolt-Glaser JK, Gouin J-P, Weng N-P, Malarkey WB, Beversdorf DQ, Glaser R. Childhood adversity heightens the impact of later-life caregiving stress on telomere length and inflammation. Psychosom Med. 2011;73(1):16–22. https://doi.org/10.1097/PSY.0b013e31820573b6.

    Article  PubMed  Google Scholar 

  61. Dinan TG. Inflammatory markers in depression. Curr Opin Psychiatry. 2008;22(1):32–6.

    Article  Google Scholar 

  62. Skare T, da Magalhães VD, Siqueira RE. Systemic lupus erythematosus activity and depression. Rheumatol Int. 2014;34(3):445–6. https://doi.org/10.1007/s00296-012-2618-7.

    Article  PubMed  Google Scholar 

  63. Tay SH, Cheung PPM, Mak A. Active disease is independently associated with more severe anxiety rather than depressive symptoms in patients with systemic lupus erythematosus. Lupus. 2015;24(13):1392–9. https://doi.org/10.1177/0961203315591026.

    Article  CAS  PubMed  Google Scholar 

  64. Shortall E, Isenberg D, Newman SP. Factors associated with mood and mood disorders in SLE. Lupus. 1995;4(4):272–9. https://doi.org/10.1177/096120339500400407.

    Article  CAS  PubMed  Google Scholar 

  65. Huang X, Magder LS, Petri M. Predictors of incident depression in systemic lupus erythematosus. J Rheumatol. 2014;41(9):1823–33. https://doi.org/10.3899/jrheum.140111.

    Article  PubMed  Google Scholar 

  66. Jarpa E, Babul M, Calderón J, González M, Martínez ME, Bravo-Zehnder M, et al. Common mental disorders and psychological distress in systemic lupus erythematosus are not associated with disease activity. Lupus. 2011;20(1):58–66. https://doi.org/10.1177/0961203310381773.

    Article  CAS  PubMed  Google Scholar 

  67. Hawro T, Krupinska-Kun M, Rabe-Jablonska J, Sysa-Jedrzejowska A, Robak E, Bogaczewicz J, et al. Psychiatric disorders in patients with systemic lupus erythematosus: association of anxiety disorder with shorter disease duration. Rheumatol Int. 2011;31(10):1387–91. https://doi.org/10.1007/s00296-010-1689-6.

    Article  CAS  PubMed  Google Scholar 

  68. Colasanti T, Delunardo F, Margutti P, Vacirca D, Piro E, Siracusano A, et al. Autoantibodies involved in neuropsychiatric manifestations associated with systemic lupus erythematosus. J Neuroimmunol. 2009;212(1–2):3–9. https://doi.org/10.1016/j.jneuroim.2009.05.003.

    Article  CAS  PubMed  Google Scholar 

  69. Meszaros ZS, Perl A, Faraone SV. Psychiatric symptoms in systemic lupus erythematosus: a systematic review. J Clin Psychiatry. 2012;73(7):993–1001. https://doi.org/10.4088/JCP.11m07043.

    Article  CAS  PubMed  Google Scholar 

  70. • Ho RC, Thiaghu C, Ong H, Lu Y, Ho CS, Tam WW, et al. A meta-analysis of serum and cerebrospinal fluid autoantibodies in neuropsychiatric systemic lupus erythematosus. Autoimmun Rev. 2016;15(2):124–38. https://doi.org/10.1016/j.autrev.2015.10.003 Most recent and thorough systematic review of all autoantibody studies for their association with specific NPSLE syndromes, including anxiety and depression.

    Article  CAS  PubMed  Google Scholar 

  71. Mak A, Tang C, Ho R. Serum tumour necrosis factor-alpha is associated with poor health-related quality of life and depressive symptoms in patients with systemic lupus erythematosus. Lupus. 2013;22(3):254–61. https://doi.org/10.1177/0961203312471872.

    Article  CAS  PubMed  Google Scholar 

  72. Strawbridge R, Arnone D, Danese A, Papadopoulos A, Herane Vives A, Cleare AJ. Inflammation and clinical response to treatment in depression: a meta-analysis. Eur Neuropsychopharmacol. 2015;25(10):1532–43. https://doi.org/10.1016/j.euroneuro.2015.06.007.

    Article  CAS  PubMed  Google Scholar 

  73. Chiu WC, Su YP, Su KP, Chen PC. Recurrence of depressive disorders after interferon-induced depression. Transl Psychiatry. 2017;7(2):e1026. https://doi.org/10.1038/tp.2016.274.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Husain MI, Strawbridge R, Stokes PR, Young AH. Anti-inflammatory treatments for mood disorders: systematic review and meta-analysis. J Psychopharmacol. 2017;31(9):1137–48. https://doi.org/10.1177/0269881117725711.

    Article  CAS  PubMed  Google Scholar 

  75. Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Rev Immunol. 2016;16(1):22–34. https://doi.org/10.1038/nri.2015.5.

    Article  CAS  Google Scholar 

  76. Euesden J, Danese A, Lewis CM, Maughan B. A bidirectional relationship between depression and the autoimmune disorders – new perspectives from the national child development study. PLoS One. 2017;12(3):e0173015. https://doi.org/10.1371/journal.pone.0173015.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Wekking EM. Psychiatric symptoms in systemic lupus erythematosus: an update. Psychosom Med. 1993;55(2):219–28.

    Article  CAS  Google Scholar 

  78. Iverson GL, McCracken LM. Attributing psychopathology to systemic lupus erythematosus: some methodological considerations. Ann Rheum Dis. 1992;51(1):134–5.

    Article  CAS  Google Scholar 

  79. Feinstein A. Multiple sclerosis and depression. Mult Scler. 2011;17(11):1276–81. https://doi.org/10.1177/1352458511417835.

    Article  PubMed  Google Scholar 

  80. Marrie RA, Patten SB, Berrigan LI, Tremlett H, Wolfson C, Warren S, et al. Diagnoses of depression and anxiety versus current symptoms and quality of life in multiple sclerosis. Int J MS Care. 2018;20(2):76–84. https://doi.org/10.7224/1537-2073.2016-110.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Jensen P, Ahlehoff O, Egeberg A, Gislason G, Hansen P, Skov L. Psoriasis and new-onset depression: a Danish Nationwide Cohort Study. Acta Derm Venereol. 2016;96(1):39–42. https://doi.org/10.2340/00015555-2183.

    Article  CAS  PubMed  Google Scholar 

  82. Borowoy AM, Pope JE, Silverman E, Fortin PR, Pineau C, Smith CD, et al. Neuropsychiatric lupus: the prevalence and autoantibody associations depend on the definition: results from the 1000 faces of lupus cohort. Semin Arthritis Rheum. 2012;42(2):179–85. https://doi.org/10.1016/j.semarthrit.2012.03.011.

    Article  PubMed  Google Scholar 

  83. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on alcoholism and related conditions. Arch Gen Psychiatry. 2005;62(10):1097–106. https://doi.org/10.1001/archpsyc.62.10.1097.

    Article  PubMed  Google Scholar 

  84. Chin CN, Cheong I, Kong N. Psychiatric disorder in Malaysians with systemic lupus erythematosus. Lupus. 1993;2(5):329–32.

    Article  CAS  Google Scholar 

  85. Ishikura R, Morimoto N, Tanaka K, Kinukawa N, Yoshizawa S, Horiuchi T, et al. Factors associated with anxiety, depression and suicide ideation in female outpatients with SLE in Japan. Clin Rheumatol. 2001;20(6):394–400.

    Article  CAS  Google Scholar 

  86. Hay EM, Black D, Huddy A, Creed F, Tomenson B, Bernstein RM, et al. Psychiatric disorder and cognitive impairment in systemic lupus erythematosus. Arthritis Rheum. 1992;35(4):411–6.

    Article  CAS  Google Scholar 

  87. Nishimura K, Omori M, Katsumata Y, Sato E, Kawaguchi Y, Harigai M, et al. Psychological distress in corticosteroid-naive patients with systemic lupus erythematosus: a prospective cross-sectional study. Lupus. 2016;25(5):463–71. https://doi.org/10.1177/0961203315615223.

    Article  CAS  PubMed  Google Scholar 

  88. Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M, Terroso G, Figueiredo M, et al. Depression and anxiety in systemic lupus erythematosus: the crosstalk between immunological, clinical, and psychosocial factors. Medicine. 2018;97(28):e11376.

    Article  Google Scholar 

  89. • Wang Q, Yang C, Gelernter J, Zhao H. Pervasive pleiotropy between psychiatric disorders and immune disorders revealed by integrative analysis of multiple GWAS. Hum Genet. 2015;134:1195–209. https://doi.org/10.1007/s00439-015-1596-8 First ever study looking at genetic loci that are associated with both psychiatric illnesses, including major depression, and autoimmune diseases, including SLE.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M, et al. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14(1):S1. https://doi.org/10.1186/1471-244x-14-s1-s1.

    Article  PubMed  PubMed Central  Google Scholar 

  91. RM MC, Vanderlip ER, Rado J. Depression. Ann Intern Med. 2016;165(7):ITC49–64. https://doi.org/10.7326/AITC201610040.

    Article  Google Scholar 

  92. Kennedy SH, Lam RW, RS MI, Tourjman SV, Bhat V, Blier P, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 3. pharmacological treatments. Can J Psychiatry. 2016;61(9):540–60. https://doi.org/10.1177/0706743716659417.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Bertsias GK, Ioannidis JPA, Aringer M, Bollen E, Bombardieri S, Bruce IN, et al. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010;69(12):2074–82. https://doi.org/10.1136/ard.2010.130476.

    Article  CAS  PubMed  Google Scholar 

  94. van Exel E, Jacobs J, Korswagen LA, Voskuyl AE, Stek M, Dekker J, et al. Depression in systemic lupus erythematosus, dependent on or independent of severity of disease. Lupus. 2013;22(14):1462–9. https://doi.org/10.1177/0961203313508443.

    Article  PubMed  Google Scholar 

  95. Lunn MPT, Hughes RAC, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014;1. https://doi.org/10.1002/14651858.CD007115.pub3.

  96. O'Riordan R, Doran M, Connolly D. Fatigue and activity management education for individuals with systemic lupus erythematosus. Occup Ther Int. 2017;2017:11. https://doi.org/10.1155/2017/4530104.

  97. Williams EM, Hyer JM, Viswanathan R, Faith TD, Egede L, Oates JC, et al. Cytokine balance and behavioral intervention; findings from the Peer Approaches to Lupus Self-Management (PALS) project. Hum Immunol. 2017;78(9):574–81. https://doi.org/10.1016/j.humimm.2017.07.005.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Zhang J, Wei W, Wang CM. Effects of psychological interventions for patients with systemic lupus erythematosus: a systematic review and meta-analysis. Lupus. 2012;21(10):1077–87. https://doi.org/10.1177/0961203312447667.

    Article  CAS  PubMed  Google Scholar 

  99. Tan LP, Tan LE. Electroconvulsive therapy for severe neuropsychiatric lupus with psychosis. J ECT. 2013;29(3):243–6.

    Article  Google Scholar 

  100. Kenna HA, Poon AW, de los Angeles CP, Koran LM. Psychiatric complications of treatment with corticosteroids: review with case report. Psychiatry Clin Neurosci. 2011;65(6):549–60. https://doi.org/10.1111/j.1440-1819.2011.02260.x.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Rheumatology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada

    Annaliese Tisseverasinghe, Christine Peschken & Carol Hitchon

  2. Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada

    Christine Peschken

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  1. Annaliese Tisseverasinghe
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  2. Christine Peschken
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  3. Carol Hitchon
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Drs. Christine Peschken and Carol Hitchon contributed equally to the manuscript by way of manuscript revisions and advice on content.

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Correspondence to Annaliese Tisseverasinghe.

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This article is part of the Topical Collection on Health Economics and Quality of Life

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Tisseverasinghe, A., Peschken, C. & Hitchon, C. Anxiety and Mood Disorders in Systemic Lupus Erythematosus: Current Insights and Future Directions. Curr Rheumatol Rep 20, 85 (2018). https://doi.org/10.1007/s11926-018-0797-2

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