Life satisfaction (LS) has become an increasingly important outcome measure in healthcare, is a relevant indicator of job satisfaction and might be associated with depression. The objectives of the study were to investigate life and job satisfaction and the association of self-reported depressive symptomatology (DS) in patients (pts) with systemic lupus erythematosus (SLE) to consider these aspects in future treatment concepts and studies.

Methods:

Self-reported questionnaires (Qs) were applied to SLE pts and controls (c) not suffering from rheumatic diseases. General life satisfaction Q (FLZ) captured ten domains of satisfaction (see Table1). According to Q’s analysis, scores are expressed as age and sex standardized stanines (a method of scaling test scores on a normalized nine-point standard scale (1-9) with a mean of 5 and a standard deviation of 2). DS was measured using the German long version of the Center for Epidemiological Studies Depression Scale (ADS-L). A separate Q assessed self-reported clinical data. Ethics committee approval had been obtained.

Results:

252 pts (95.6% female (f)) and 177 controls (90.3% f) contributed data. Patients’ mean age was 40.1±9.4 (c 42.8±9.8) years, mean disease duration 10.5±7.3 years, mean HAQ 0.8±0.4 (c 0.4±0.1). 86.0% reported at least one comorbidity (range 0-10, c 45.2%, range 0-4). 77.4% received at least one immunosuppressive medication (range 0-3). 40.5% were on steroids <7.5mg, 16.3% on steroids >7.5mg, 34.0% took NSAIDS.

The mean general LS of pts was 237.8±39.6 (c 263.9±31.7, p<4e-10). Except in partner/relationship pts scored significantly lower in all FLZ-subscales compared to c. Pts mean ADS-L Score was 18.1±11.0, c 9.8±6.8 (p<6e-16). 30.0% pts and 4.6% c (p<3e-10) scored >23 on the ADS-L which is indicative of depression.

A logistic regression model calculated the association of LS (sub-)scale-stanines and DS. Table 1 depicts odds ratios: If the health stanine increases by one unit, a person’s risk with respect to an outcome of DS decreases by a factor of 0.462. For pts, it increases by an additional factor of 2.245. In comparison to c, SLE pts had a higher risk of DS in all FLZ (sub)scales.

Conclusion:

SLE pts showed reduced satisfaction in 10 areas of life and significantly more pts were indicative of depression. Significant ORs were detected in all FLZ scales, domains that are potentially modifiable. The very high OR in the job and profession subscale indicates that beside depression social and job related satisfaction issues should predominantly targeted. Besides from already established (QoL) assessments (e.g. HAQ, SF36) routine care and further clinical studies might gain from the additional assessment of LS and DS as outcome parameters.

Unrestricted grants: Ministry of Innovation, Science, Research and Technology of the German State North Rhine-Westphalia, Deutsche Rheuma-Liga e.V., supported by German LE Self-Help Community, Hiller Foundation