Chinese SLE Treatment and Research Group Registry (CSTAR) XIV: the subjective well-being of patients with systemic lupus erythematosus

Yue Shi; Dandan Bi; Yanhong Wang; Ruofan Li; Lijun Wu; Cheng Zhao; Zhenbiao Wu; Xinwang Duan; Jian Xu; Feng Zhan; Min Yang; Shengyun Liu; Qin Li; Shuo Zhang; Lingshan Liu; Jiuliang Zhao; Xinping Tian; Xinying Li; Qian Wang; Xiaofeng Zeng; CSTAR Co-authors

doi:10.3389/fmed.2022.984183

Chinese SLE Treatment and Research Group Registry (CSTAR) XIV: the subjective well-being of patients with systemic lupus erythematosus

Front Med (Lausanne). 2022 Sep 20:9:984183. doi: 10.3389/fmed.2022.984183. eCollection 2022.

Authors

Yue Shi¹, Dandan Bi^{2

3}, Yanhong Wang⁴, Ruofan Li⁵, Lijun Wu⁶, Cheng Zhao⁷, Zhenbiao Wu⁸, Xinwang Duan⁹, Jian Xu¹⁰, Feng Zhan¹¹, Min Yang¹², Shengyun Liu¹³, Qin Li¹⁴, Shuo Zhang¹, Lingshan Liu¹, Jiuliang Zhao¹, Xinping Tian¹, Xinying Li^{2

3}, Qian Wang¹, Xiaofeng Zeng¹; CSTAR Co-authors

Affiliations

¹ Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
² CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
³ University of Chinese Academy of Sciences, Beijing, China.
⁴ Department of Epidemiology and Biostatistics, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China.
⁵ Department of International Education, The Experimental High School Attached to Beijing Normal University, Beijing, China.
⁶ Department of Rheumatology, The People's Hospital of Xinjiang Autonomous, Urumqi, China.
⁷ Department of Rheumatology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
⁸ Department of Clinical Immunology and Rheumatology, Xijing Hospital Affiliated with The Fourth Military Medical University, Xi'an, China.
⁹ Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
¹⁰ Department of Rheumatology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
¹¹ Department of Rheumatology, Hainan Provincial People's Hospital, Haikou, China.
¹² Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
¹³ Department of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹⁴ Department of Rheumatology, The First People's Hospital of Yunnan Province, Kunming, China.

Abstract

Background: Systemic lupus erythematosus (SLE) can significantly influence patients' quality of life and subjective well-being (SWB), but the relationships between clinical characteristics, SWB, and related psychological factors have been little studied.

Objective: To measure SWB in patients with SLE and examine how major clinical determinants, emotional variables, and related positive factors affect SWB.

Methods: Overall, 1,110 patients with SLE from the Chinese SLE Treatment and Research Group (CSTAR) and 198 age and gender-matched individuals from the general population without self-reported SLE were invited to complete questionnaires of SWB evaluated by the satisfaction with life scale (SWLS), emotional variables assessed by the patient health questionnaire-9 (PHQ-9), and general anxiety disorder-7 (GAD-7) and related positive factors assessed by the self-esteem scale (SES), general self-efficacy scale (GESE), and Connor-Davidson resilience scale (CD-RISC). The multivariate linear regression was used to examine the relationship between clinical manifestations and SWB.

Results: Life satisfaction was significantly lower (p < 0.001) in patients with SLE than in the general population. Active skin involvement (OR = 0.923, 95% CI = 0.868-0.981, p < 0.05) was negatively associated with life satisfaction scores, and age at enrollment (OR = 1.160, 95% CI = 1.092-1.230, p < 0.001) were positively associated with life satisfaction scores in the multivariate regression model. The cumulative organ damage was significantly associated with depression (OR = 1.085, 95% CI = 1.022-1.153, p < 0.01) and the loss of self-esteem (OR = 1.067, 95% CI = 1.004-1.133, p < 0.05).

Conclusion: SWB provides useful insight into the impact of SLE on psychological health and opportunities to improve quality of life and clinical care.

Keywords: life satisfaction; organ damage; quality of life; skin involvement; subjective well-being; systemic lupus erythematosus.