Prevalence of Depression and the Quality of Life of Patients With Systemic Lupus Erythematosus Attending the Rheumatology Clinic in Kenyatta National Hospital

Abstract

Background Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by inflammation of various organs. Neuropsychiatric manifestations such as symptoms of depression may precede SLE, occur concomitantly, or follow its diagnosis. Depression, in particular, further exacerbates the morbidity of patients with SLE and is thought to be correlated with a lower quality of life. Depression is not routinely evaluated in patients with SLE in Kenya, which can lead to a reduction in its treatment and potentially worsen the morbidity of the disease. Objective To determine the burden, impact and determinants of depression in patients with SLE Methods A descriptive cross-sectional study was conducted at the rheumatology clinic in Kenyatta National Hospital (KNH) from November 2022 to January 2023. Depression was evaluated using the Patient Health Questionnaire 9 (PHQ-9), while quality of life was assessed using the Short Form 36 Health Survey Questionnaire (SF-36). Data analysis was performed using International Business Machines (IBM) SPSS Statistics (Version 25). The prevalence of depression was determined by calculating the proportion of participants who reported depression, and the association between depression and quality of life scores was assessed using the Chi-square test at a 95% confidence level. A probability value of <0.05 was considered significant. Results xiii Fifty-five SLE patients were recruited in the study. Depression symptoms were reported among 24/55 (43.6%) of patients. 34/55 (63.0%), 31/55 (57.4%), 26/55 (48.1%), and 18/55(32.7%) had poor role limitations due to physical health, poor role limitations due to emotional problems, pain, and low energy or fatigue. The odds of depression were higher among patients who had poor physical functioning (OR=14.5, 95% CI, 1.7-26.6), p=0.003, poor role limitations due to emotional problems (OR=5.7, 95% CI, 1.7-9.4), p=0.004, and poor health change (OR=7.0, 95% CI=1.3-37.1), p=0.012. Conclusion A high prevalence of depression was noted in patients with SLE. The afflicted had significant role limitations due to emotional problems, poor physical functioning, and poor health change. This study highlights the importance of evaluating and addressing depression in patients with SLE.