Prevalence and predictors of anxiety and depression in Chinese patients with systemic lupus erythematosus: the role of self-perceived burden and medication adherence

To assess the psychological status, perceived health status, self-perceived burden, medication adherence, coping strategies and sleep quality in Chinese patients with systemic lupus erythematosus, and to explore their associations with potential clinical and disease activity factors. This was a cross-sectional study including 135 patients with SLE. Participants were asked to complete Hospital Anxiety and Depression Scale (HADS), Health assessment questionnaire disability index (HAQ-DI), Self-Perceived Burden Scale (SPBS), 8-item Morisky Medication Adherence Scale (MMAS-8), Medical Coping Modes Questionnaire (MCMQ), Fatigue Severity Scale (FSS) and Pittsburgh sleep quality index (PSQI). Independent samples t-tests, χ² analyses and stepwise multiple logistic regression were employed for data analysis. 135 patients were included in the analysis. The data showed that the rate of anxiety was 38.5% and depression was 37.0% in our investigated SLE patients. Patients with anxiety had significantly higher HAQ-DI scores, greater self-perceived burden, poorer medication adherence, and worse coping strategies and sleep quality compared to those without anxiety (p < 0.05). In comparisons between patients with and without depression, significant differences were found in age, education level, TSGF, perceived health status, HAQ-DI, FSS, SPBS, MMAS-8, and PSQI. Meanwhile, SPBS and MMAS-8 were identified as predictors of anxiety, while perceived health status, HAQ-DI, and education level were predictors of depression. Anxiety and depression were exceedingly common among Chinese patients with SLE, particularly in patients with lower medication adherence, more self-perceived burden, worse health status and functionality. These findings could aid clinicians in developing targeted interventions to improve the psychological well-being of patients with SLE.