Background/Purpose: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with psychiatric comorbidities, including depression and suicidal ideation. However, national trends over time have not been fully characterized.

Methods: We conducted a retrospective cross-sectional analysis using NIS data from 2016–2020. Adult patients (age ≥18) diagnosed with SLE were identified using ICD-10 codes. Suicidal ideation was detected using diagnosis code R45.851. Weighted survey procedures were applied for national estimates. Secondary outcomes included age, sex, race, and psychiatric comorbidities such as generalized anxiety disorder, depression, bipolar disorder, and psychotic disorders.

Results: The total weighted number of SLE hospitalizations from 2016 to 2020 was approximately 245,300 patients. Among these, 1.31% had documented suicidal ideation. Patients with suicidal ideation were notably younger, with a mean age of 42.1 years, compared to 47.3 years among those without (p < 0.001). No significant differences were observed between males and females. However, there were clear racial disparities, with White patients accounting for the highest proportion of suicidal ideation cases (53.6%). Psychiatric comorbidities—including anxiety disorders, bipolar disorder, psychotic disorders, and substance abuse—were all significantly associated with increased suicidal ideation (p < 0.001). Trend analysis revealed that suicidal ideation cases rose from 675 in 2016 to a peak of 955 in 2017, before steadily declining to 350 in 2020. During the same period, overall SLE hospitalizations also showed a decreasing trend.

Conclusion: Although the overall rate of suicidal ideation among hospitalized SLE patients remains low, psychiatric comorbidities significantly increase risk. After a peak in 2017, a decreasing trend was observed through 2020, likely due to improved psychiatric screening, advances in SLE treatment, multidisciplinary care approaches, and increased recognition of neuropsychiatric risk factors.

SLE hospitalizations (blue bars)

Suicidal ideations (red line)

From 2016 to 2020.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-and-trends-of-suicidal-ideation-among-hospitalized-adults-with-systemic-lupus-erythematosus-sle-a-national-inpatient-sample-analysis-2016-2020/