The risk for depression is significantly increased in patients with systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE), according to the results of a nationwide, observational cohort study published in the British Journal of Dermatology.
The study included patients age ≥18 with a first-time diagnosis of SLE or CLE between 2000 and 2015 who were identified in the Danish National Patient Register and matched with the general population. The baseline or index date for CLE or SLE was identified as the date of the initial diagnosis, and each case was matched according to age, gender, and index date in a 1:10 ratio with individuals from the general population, who served as the control group.
Overall, 3489 patients with SLE or CLE were followed for a total of 23,373 person-years. The adjusted hazard ratios (aHRs) for depression were 2.07 (95% CI, 1.55-2.75) and 2.22 (95% CI, 1.77-2.77) in patients with CLE and SLE, respectively, compared with the general population. Moreover, aHRs for hospitalization due to depression were 2.63 (95% CI, 0.80-8.67) and 3.52 (95% CI, 1.53-8.11) in individuals with CLE and SLE, respectively. In addition, the aHRs of antidepressant use were 1.47 (95% CI, 1.34-1.63) and 1.70 (95% CI, 1.58-1.83) in patients with CLE and SLE, respectively.
The investigators concluded that because the risk for depression was of a similar magnitude in patients with CLE and patients with SLE, involvement of the skin as well as the systemic involvement of the disease may affect patients’ overall risk for depression. Both rheumatologists and dermatologists should be aware of the increased risk for depression in patients with SLE and CLE.
Hesselvig JH, Egeberg A, Kofoed K, Gislason G, Dreyer L. Increased risk of depression in patients with cutaneous lupus erythematosus and systemic lupus erythematosus: a Danish nationwide cohort study [published online June 9, 2018]. Br J Dermatol. doi: 10.1111/bjd.1683