Clinical Rheumatology

, Volume 30, Issue 6, pp 795–803 | Cite as

Damage accrual, cumulative glucocorticoid dose and depression predict anxiety in patients with systemic lupus erythematosus

  • Anselm MakEmail author
  • Catherine So-Kum Tang
  • Moon-Fai Chan
  • Alicia Ai-Cia Cheak
  • Roger Chun-Man Ho
Original Article


The burden of anxiety in patients with systemic lupus erythematosus (SLE) compared to those with other inflammatory rheumatological conditions is unclear. We aimed to compare the frequency and level of anxiety between patients with SLE, rheumatoid arthritis (RA), and gout and healthy individuals and explore independent predictors for anxiety in SLE patients. Consecutive patients with SLE, RA and gout and healthy individuals who were age and sex matched with the SLE group were evaluated for anxiety using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and disease-related variables were compared between all groups. Predictors for anxiety were studied by regression models, with construction of a prediction model for the presence of anxiety in SLE patients by the receiver operating characteristic (ROC) analysis. Amongst 271 subjects studied, 60 had lupus, 50 had gout, 100 had RA and 61 were healthy controls. The frequency and level of anxiety were significantly higher in SLE patients than patients with gout, RA and healthy controls. SLE per se was independently associated with higher HADS-anxiety score after controlling for potential confounders. Logistic regression model showed that higher damage accrual, higher cumulative glucocorticoid dose, depression and fewer regular medications predicted anxiety in SLE patients, with an accuracy of 90% by the ROC analysis.


Anxiety Comparative Lupus Mood Prediction model 



We would like to thank the clinicians of the Department of Medicine, National University Health System, Singapore, for referral of patients who agreed to join the current studies.




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Copyright information

© Clinical Rheumatology 2011

Authors and Affiliations

  • Anselm Mak
    • 1
    Email author
  • Catherine So-Kum Tang
    • 4
  • Moon-Fai Chan
    • 3
  • Alicia Ai-Cia Cheak
    • 1
  • Roger Chun-Man Ho
    • 2
  1. 1.Division of Rheumatology, Department of MedicineYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
  2. 2.Department of Psychological MedicineNational University of SingaporeSingaporeSingapore
  3. 3.Department of NursingYong Loo Lin School of MedicineSingaporeSingapore
  4. 4.Department of Psychology, Faculty of Arts and Social SciencesNational University of SingaporeSingaporeSingapore

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