Background/Purpose: Suicide and depression represent a high burden of morbidity and mortality worldwide. It is well known that fibromyalgia (FM) is associated with mood and behavioral disorders. FM is extremely common in patients with systemic lupus erythematosus (SLE) even though FM does not correlate with SLE activity. We investigate the rate of concomitant depressive disorder and suicide attempts in patients with SLE.

Methods: TrinetX, a global federated research network that provides a dataset of electronic medical records from different healthcare organizations (HCOs) was utilized. Initial query was made on June 6, 2023 from 1/1/2010 to 6/6/2023 to identify patients aged >18 with a diagnosis of “Systemic Lupus Erythematosus” (International Classification of Diseases, 10th version (ICD-10) Code M32). Two cohorts were made, on the basis of the presence of a diagnosis of “Fibromyalgia” (ICD-10 Code M79.7). Propensity score matching was carried out to match age, race , and gender. Compare outcome analytic function was utilized to map the correlation with “Suicide attempt” (ICD 10 Code T14.91) and “Major Depressive Disorder (MDD)” (ICD 10 Code F33), and prevalence Odds ratios (OR) were calculate

Results: We identified cohort 1 as patients with concomitant diagnoses of SLE and FM with a total of 55,350 patients. Cohort 2 as SLE patients without FM included 219,914 patients. Using propensity score matching, patients with SLE but without FM were matched 1:1 to 53,221 patients with both SLE and FM. Data demonstrated mean age of 55.6 years (SD 14.6). Percentage of females in cohort 1 was 93.978% and 93.969% in cohort 2 with the white race being the most prevalent followed by unknown ethnicity, African-American and Asian. A total of 5,864 patients with SLE and FM also had a diagnosis of “Major Depressive Disorder” (ICD 10 Code F33), compared to 2,255 patients without FM, with a 6.781% risk difference (95% CI – 6.465%-7.097%, p < 0.0001), and Odds ratio of 2.799 (2.662-2.943, p< 0.0001). In addition, 625 patients with SLE and FM also had a diagnosis of “Suicide Attempt” (ICD 10 Code T14.91), compared to 238 patients without FM, with 0.727% risk difference (95% CI – (0.619%,0.835%), p < 0.0001), and Odds ratio of 2.645 (2.277-3.073, p< 0.0001), see table 1. Similar results were identified before propensity score matching, with OR of concomitant MDD in patients with SLE and FM compared to the cohort without FM being 3.146 (3.037-3.258, p< 0.0001) and OR of Suicide Attempt being 2.653 (2.396-2.938, p < 0.0001.

Conclusion: In this real-world, real-time study, patients with SLE and concomitant fibromyalgia have increased risk of major depressive disorder and suicide attempt when compared with SLE patients without fibromyalgia.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/depression-and-suicide-attempt-in-systemic-lupus-erythematosus-with-and-without-fibromyalgia/