Factors Associated with Psychosomatic Disorders Among Systemic Lupus Erythematosus (SLE) Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic
Abstract
Background: The COVID-19 pandemic has affected physical and mental health. SLE patients are prone to psychosomatic disorders which can decrease their quality of life. This study aimed to determine the factors associated with psychosomatic disorders among SLE patients during the COVID-19 pandemic. Methods: This was a cross-sectional study of adult female SLE patients from the outpatient clinic of Cipto Mangunkusumo Hospital, Jakarta. Data regarding psychosomatic disorders were collected using SCL-90 questionnaires, and data on demographic factors, perception of COVID-19 conditions, perception of stress, psychosocial stressors, disease activity (MEX-SLEDAI), and treatment were also collected. Bivariate analysis for categorical data was conducted using the Chi-square test. Variables with a p-value <0.25 were further analyzed with logistic regression, and p-values <0.05 were considered significant. Meanwhile, data per domain were analyzed using the Mann-Whitney test with p-values < 0.05 being considered significant. Results: There were 200 female SLE patients recruited. More than half of the subjects (54%) experienced psychosomatic disorders. From multivariate analysis, high educational levels, moderate and high psychosocial stressors, and very severe disease activity levels were found to be significantly associated with the occurrence of psychosomatic disorders in SLE patients during the COVID-19 pandemic. Conclusion: Education level, psychosocial stressors, and disease activity level were found to be significantly associated with the occurrence of psychosomatic disorders in SLE patients during the COVID-19 pandemic.
Keywords
References
Fu XL, Qian Y, Jin XH, et al. COVID-19 in patients with systemic lupus erythematosus: a systematic review. Lupus. 2022;31(6):684-96. doi: 10.1177/09612033221093502.
Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91(1):157-60. doi: 10.23750/abm.v91i1.9397.
Ruiz RF, Paredes JL, Niewold TB. COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease. Transl Res. 2021; 232:13-36. doi: 10.1016/j.trsl.2020.12.007.
Bruera S, Lei X, Zhao H, et al. Risk of mortality and severe coronavirus disease 19 (COVID 19) outcomes in patients with or without systemic lupus erythematosus. Lupus Sci Med. 2023; 10(1):e000750. doi: 10.1136/lupus-2022-000750.
Sawalha AH, Manzi S. Coronavirus Disease-2019: Implication for the care and management of patients with systemic lupus erythematosus. Eur J Rheumatol. 2020;7(Suppl 2):S117-20. doi: 10.5152/eurjrheum.2020.20055.
De Sousa A, Mohandas E, Javed A. Psychological interventions during COVID-19: challenges for low and middle income countries. Asian J Psychiatr. 2020; 51:102128. doi: 10.1016/j.ajp.2020.102128.
Olesinska M, Saletra A. Quality of life in systemic lupus erythematosus and its measurement. Reumatologia. 2018;56(1):45-54. doi: 10.5114/reum.2018.74750.
Yue Y, Li L, Liu R, et al. The dynamic changes of psychosomatic symptoms in three waves of COVID-19 outbreak and fatigue caused by enduring pandemic in China. J Affect Disord. 2023:17-24. doi: 10.1016/j.jad.2023.03.032.
Wankowicz P, Szylinska A, Rotter I. Evaluation of mental health factors among people with systemic lupus erythematosus during the SARS-CoV-2 pandemic. J Clin Med. 2020; 9(9):2872. doi: 10.3390/jcm9092872.
Torrubia-Pérez E, Reverté-Villarroya S, Fernández-Sáez J, Martorell-Poveda MA. Analysis of psychosomatic disorders according to age and sex in a rural area: A population-based study. J Pers Med. 2022; 12(10):1730. doi: 10.3390/jpm12101730.
Leung C. Risk factors for predicting mortality in elderly patients with COVID-19: a review of clinical trial data in China. Mech Ageing Dev. 2020;188:111255. doi: 10.1016/j.mad.2020.111255.
Kane PP. Stress causing psychosomatic illness among nurses. Indian J Occup Environ Med. 2009;13(1):28-32. doi: 10.4103/0019-5278.50721.
Ebner K, Singewald N. Individual differences in stress susceptibility and stress inhibitory mechanisms. Current Opinion in Behavioral Science. 2017;14:54-64. http://dx.doi.org/10.1016/j.cobeha.2016.11.016
Ward MM, Marx AS, Barry NN. Psychological distress and changes in the activity of systemic lupus erythematosus. Rheumatology. 2002; 41(2):184-8. doi: 10.1093/rheumatology/41.2.184.
Asano NMJ, Coriolano MGW, Asano BJ, Lins OG. Psychiatric comorbidities in patients with systemic lupus erythematosus: a systematic review of the last 10 years. Rev Bras Reumatol. 2013;53(5):431-7.
Dubey S, Biwas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Synd. 2020;14(5):779-88. doi: 10.1016/j.dsx.2020.05.035.
Huynh G, Reinert JP. Pharmacological management of steroid-induced psychosis: a review of patient cases. J Pharm Technol. 2021;37(2):120-6. doi: 10.1177/8755122520978534.
Widhani A, Rengganis I, Susanto AJ, et al. Factors related to knowledge, perception, and practices towards COVID-19 among patients with autoimmune disease: a multisystem online survey. Acta Med Indones. 2020;52(3):214-26.
Pin TL. Hubungan kebiasaan berolahraga dengan tingkat stres pada mahasiswa fakultas kedokteran universitas sumatera utara tahun masuk 2008. Skripsi, Medan: Fakultas Kedokteran Universitas Sumatera Utara. 2011
Noone PA. The Holmes-Rahe stress inventory. Occup Med (Lond). 2017; 67(7):581-2. doi: 10.1093/occmed/kqx099.
Herianto M. Penentuan “T score” standar normal instrument psikometrik SCL-90, dan uji coba pada pasien rawat jalan Poliklinik Jiwa Rumah Sakit Dr. Cipto Mangunkusumo Jakarta. [Masters Thesis]. Indonesia: Universitas Indonesia. 1994
Idiaiani S, Suhardi. Validitas dan reliabilitas general health questionnaire untuk skrining distress psikologik dan disfungsi sosial di masyarakat. Buletin Penelitian Kesehatan. 2005;34(4):161-73.
Wongpakaran T. Symptom checklist-90 (SCL-90) in a Thai sample. J Med Assoc Thai. 2011;94(9):1141-9.
Tian J, Zhang D, Yao C, Huang Y, Lu Q. Global epidemiology of systemic lupus erythematosus: a comprehensive systematic analysis and modelling study. Ann Rheum Dis. 2023;82(3):351-6. doi: 10.1136/ard-2022-223035.
Barber MRW, Drenkard C, Falasinnu T, et al. Global epidemiology of systemic lupus erythematosus. Nat Rev Rheumatol. 2021;17(9):515-32. doi: 10.1038/s41584-021-00668-1.
Macejova Z, Geckova AM, Husarova D, Zarikova M, Kotradyova Z. Living with systemic lupus erythematosus: a profile of young female patients. Int J Environ Res Public Health. 2020;17(4):1315. doi: 10.3390/ijerph17041315.
Peralta-Ramírez MI, Pérez-Mármol JM, Castañeda-Cabestany M, et al. Association between perceived level of stress, clinical characteristics and psychopathological symptoms in women with systemic lupus erythematosus. Clin Exp Rheumatol. 2018; 36(3):434-1.
Desai KM, Kale AD, Shah PU, Rana S. Psychosomatic disorders: a clinical perspective and proposed classification system. Arch Iran Med. 2020;21(1):44-5.
Fava GA, Cosci F, Sonino N. Current psychosomatic practice. Psychother Psychosom. 2017;86(1):13-30. doi: 10.1159/000448856.
Santos-Ruiz A, Montero-López E, Ortego-Centeno N, Peralta-Ramírez MI. Effect of COVID-19 confinement on the mental status of patients with systemic lupus erythematosus. Med Clin (Engl Ed). 2021;156(8):379-85. doi: 10.1016/j.medcle.2020.12.009.
Tian F, Li H, Tian S, Yang J, Shao J, Tian C. Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19. Psychiatry Res. 2020;288:112992. doi: 10.1016/j.psychres.2020.112992.
Meszaros ZS, Perl A, Faraone SV. Psychiatric symptoms in systemic lupus erythematosus: a systematic review. J Clin Psychiatry. 2012;73(7):993-1001.
Shenavandeh S, Mani A, Eazadnegahdar M, Nekooeian A. Medication adherence of patients with systemic lupus erythematosus and rheumatoid arthritis considering the psychosocial factors, health literacy and current life concerns of patients. Curr Rheumatol Rev. 2021;17(4):412-20. doi: 10.2174/1573397117666210301144651.
Liao J, Kang J, Li F, et al. A cross-sectional study on the association of anxiety and depression with the disease activity of systemic lupus erythematosus. BMC Psychiatry. 2022;22(1):591. doi: 10.1186/s12888-022-04236-z.
Wang X, Zhang X, Tang Y, et al. The prolonged COVID-19 pandemic caused significant psychosomatic symptoms in frontline healthcare workers. Psychiatry Res. 2023;321:115060. doi: 10.1016/j.psychres.2023.115060.
Egede LE, Walker RJ, Dawson AZ, et al. Short-term impact of COVID-19 on quality of life, perceived stress, and serious psychological distress in an adult population in the midwest United States. Qual Life Res. 2022;31(8):2387-96. doi: 10.1007/s11136-022-03081-7.
Mei R, Peng F, Xiong J, Liu C, Liu X, Wang F, Lv L. Mindfulness-based interventions for the occurrence of postpartum depression in elderly primiparas. Contrast Media Mol Imaging. 2022;2022:4202676. doi: 10.1155/2022/4202676.
Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med. 2020;26(1):13-22. doi: 10.1080/13548506.2020.1746817.
Mohamed MH, Gopal S, Idris IB, Aizuddin AN, Miskam HM. Mental health among systemic lupus erythematosus patients at tertiary hospital in Malaysia. ASWJ. 2020;5(3):30-9.
Niemeyer H, Bieda A, Michalak J, Schneider S, Margraf J. Education and mental health: Do psychosocial resources matter? SSM Popul Health. 2019; 7:100392. doi: 10.1016/j.ssmph.2019.100392.
Kondirolli F, Sunder N. Mental health effects of education. Health Econ. 2022; 31 Suppl 2(Suppl 2):22-39. doi: 10.1002/hec.4565.
Belo P, Navarro-Pardo E, Pocinho R, Carrana P, Margarido C. Relationship between mental health and the education level in elderly people: Mediation of leisure attitude. Front Psychol. 2020;11:573. doi: 10.3389/fpsyg.2020.00573.
Rafaat HA, El Refai RM, Alrasheed HA, El Din MN. Major depression and disease activity among systemic lupus erythematosus Egyptian females. The Egyptian Rheumatologist. 2015;37:S1-S6.
Brown ES, Chandler PA. Mood and cognitive changes during systemic corticosteroid therapy. Prim care Companion J Clin Psychiatry. 2001;3(1):17-21. doi: 10.4088/pcc.v03n0104.
Alturaymi MA, Almadhi OF, Alageel YS, Dayel M, Alsubayyil MS, Alkhateeb BF. The association between prolonged use of oral corticosteroids and mental disorders: do steroids have a role in developing mental disorders? Cureus. 2023;15(4):e37627. doi: 10.7759/cureus.37627.
Lu Y, Ann L, McCarron R. Steroid-induced psychiatric symptoms: what you need to know. Current Psychiatry. 2021;20(4):33-8.
Atas DB, Sunbul EA, Velioglu A, Tuglular S. The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during COVID-19 pandemic. PLOS ONE. 2021;16(3):e0248117. doi: 10.1371/journal.pone.0248117.
Shen B, Tai W, Feng G, et al. The correlation of disease activity, socioeconomic status, quality of life, and depression/anxiety in Chinese patients with systemic lupus erythematosus. Clin Dev Immunol. 2013:1-6.
Pawlak CR, Witte T, Heiken H, et al. Flares in patients with systemic lupus erythematosus are associated with daily psychological stress. Psychother Psychosom. 2003;72(3):159-65. doi: 10.1159/000069735.
Sakr BR, Seif EM, Kamel RM, Eleishi HH. Impact of psycho-educational therapy on disease activity, quality of life, psychological status, treatment satisfaction and adherence in systemic lupus erythematosus patients. The Egyptian Rheumatologist. 2022:44 (4):313-7.
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