Body image in lupus: Is it disease activity, physical function, depression, pain, fatigue, sleep, fibromyalgia or stress?
Journal Title: International Journal of Clinical Rheumatology - Year 2018, Vol 13, Issue 4
Abstract
Patients with systemic lupus erythematosus (SLE) frequently experience poor body image (BI), an important issue, though not well researched or understood thus far. BI is perception of one’s own body. The effects of disease activity, damage, sleep, stress, pain, fatigue, function, medications, depression and fibromyalgia (FM) on BI in SLE are not known. Objective: We aimed to evaluate the relative role of the specific variables listed above on BI in SLE patients. Methods: SLE patients receiving rheumatology care at two academic medical centers were recruited. Each patient completed questionnaire assessments evaluating target variables and BI. Disease activity was evaluated using SELENA-SLEDAI. Multivariate regression analyses including stepwise modeling were conducted with BI as the dependent variable for all patients and for patients with and without FM. Results: 115 SLE patients participated. Mean (SD) age was 40.1 (13.8) years. For all patients and patients without FM, depression (β -1.7, p 0.02), stress (β -1.8, p 0.05), ACR malar rash (β -13.5, p 0.03), and steroid dose (β -0.4, p 0.04) were found to be independent predictors of BI, and explained 54% of BI variance. On stepwise regression modelling, scores for depression (β -2.2, p <0.001), stress (β -1.6, p 0.05), and disease activity (β -1.5, p 0.005) were found to be predictive of poor BI in the whole group, and similar results were noted among those without fibromyalgia. Malar rash presence as defined in the ACR classification criteria for SLE (β -10.3, p 0.04) was most predictive of poor BI among patients without fibromyalgia. Of the modifiable variables among those without FM, depression and stress had similar contributions to BI, followed by disease activity. In patients with fibromyalgia, depression (β -3.6, p 0.002) alone was associated with BI. Conclusions: Depression, stress, and disease activity are important predictors of BI in SLE patients. Malar rash is a risk for poor BI among those without FM. Attention to depression and stress concurrently with control of disease is suggested among SLE patients with poor BI.
Authors and Affiliations
Stacy L Weinberg, Nisarg Gandhi, Shilpa Arora, Winston Sequeira, Mondira Sengupta, Joel A Block, Meenakshi Jolly
Keywords
Related Articles
- EP ID EP604620
- DOI -
- Views 67
- Downloads 0
A rare complex mutation in FMF gene; genetics and treatment decisions in Familial Mediterranean Fever patients
Introduction: FMF is an autosomal-recessive autoinflammatory disease characterized by episodic, self-limiting attacks characterized by fever, abdominal pain, pleurisy, arthritis and erysipelas-like-erythema. Systemic amy...
Heart failure with preserved ejection fraction in rheumatoid arthritis and the role of interleukin-6 blockade
There is growing evidence on the potential benefits of tocilizumab on the cardiovascular system in Rheumatoid Arthritis (RA) patients. We discuss a case of active RA and refractory Heart Failure with Preserved Ejection F...
Adalimumab induced chronic interstitial nephritis: a controlled blinded trial in mice
Background: Adalimumab is a known drug modifying agent for rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) treatment. However little is known about the risk of nephrotoxicity. To determine whether the i...
Spondyloarthropathies: are there any differences between Caucasians and southeast Asians living in north-east London in terms of disease onset and progression subject to cultural, social and treatment applications
Objective: To compare PSpo patients with those with predominantly peripheral disease. Method: Retrospective cross-sectional analysis of 155 patients with PsA. Results: 127 patients (81.9%) had peripheral and 28 patients...
Rituximab can induce remission in a patient with rheumatoid arthritis and Ankylosing spondylitis
The efficacy of Rituximab (RTX) has been examined in Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA) before. Here, we have reported the case of a patient with RA and AS showing good clinical improvement with RT...