Ting Fu

Prevalence of depression and anxiety in systemic lupus erythematosus: a systematic review and meta-analysis

BackgroundSystemic lupus erythematosus (SLE) patients are at high risk for depression and anxiety. However, the estimated prevalence of these disorders varies substantially between studies. This systematic review aimed to establish pooled prevalence levels of depression and anxiety among adult SLE patients.MethodsWe systematically reviewed databases including PubMed, Embase, PsycINFO, and the Cochrane database library from their inception to August 2016. Studies presenting data on depression and/or anxiety in adult SLE patients and having a sample size of at least 60 patients were included. A random-effect meta-analysis was conducted on all eligible data.ResultsA total of 59 identified studies matched the inclusion criteria, reporting on a total of 10828 adult SLE patients. Thirty five and thirteen methods of defining depression and anxiety were reported, respectively. Meta-analyses revealed that the prevalence of major depression and anxiety were 24% (95% CI, 16%-31%, I2 = 95.2%) and 37% (95% CI, 12%–63%, I2 = 98.3%) according to clinical interviews. Prevalence estimates of depression were 30% (95% CI, 22%–38%, I2 = 91.6%) for the Hospital Anxiety and Depression Scale with thresholds of 8 and 39% (95% CI, 29%–49%, I2 = 88.2%) for the 21-Item Beck Depression Inventory with thresholds of 14, respectively. The main influence on depression prevalence was the publication years of the studies. In addition, the corresponding pooled prevalence was 40% (95% CI, 30%–49%, I2 = 93.0%) for anxiety according to the Hospital Anxiety and Depression Scale with a cutoff of 8 or more.ConclusionsThe prevalence of depression and anxiety was high in adult SLE patients. It indicated that rheumatologists should screen for depression and anxiety in their patients, and referred them to mental health providers in order to identify effective strategies for preventing and treating depression and anxiety among adult SLE patients.Trial registrationCurrent Meta-analysis PROSPERO Registration Number: CRD 42016044125. Registered 4 August 2016.

Treatment adherence to disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis.

Objective Nonadherence in rheumatoid arthritis (RA) patients using disease-modifying antirheumatic drugs (DMARDs) may lead to joint damage and function loss. The aim of this cross-sectional study was to explore Chinese RA patients’ adherence rates and investigate potential risk factors for nonadherence. Methods A total of 122 RA patients were recruited from the Affiliated Hospital of Nantong University from January 2014 to April 2015. Patients were asked to complete a set of standardized self-report questionnaires (Compliance Questionnaire on Rheumatology, Health Assessment Questionnaire, Short Form-36 questionnaire, 28-joint Disease Activity Score, Hospital Anxiety and Depression Scale, and Visual Analog Scale). Independent samples t-tests, chi-square analyses, and logistic regression modeling were used to analyze these data. Results Based on Compliance Questionnaire on Rheumatology, 38% of the patients adhered to DMARDs. Adherence was associated with education, income, depression, and the total number of DMARDs. Other demographic and clinical characteristics were not associated with adherence. Logistic regression models identified income, depression, and the total number of DMARDs as predictors of medication nonadherence. Conclusion In this study, 62% of patients with RA were not adherent to their DMARD prescription. Education, income, depression, and the total number of DMARDs were associated with medication adherence, and income, depression, and the total number of DMARDs were independent predictors of medication adherence in patients with RA. These findings could help medical personnel develop helpful interventions to improve adherence in RA patients by paying more attention to the patients with these accompanying risk factors and, finally, improve RA patients’ quality of life.

Rate of adherence to urate-lowering therapy among patients with gout: a systematic review and meta-analysis

Introduction Reported adherence to urate-lowering therapy (ULT) in gout varies widely (17%–83.5%). Variability may partly be due to different adherence measurement methods. This review aimed to quantify ULT adherence in adult patients with gout. Methods This analysis examined studies in PubMed, Web of Science, CNKI Scholar and WanFang databases from inception to January 2017. Papers were selected by inclusion and exclusion criteria in the context. Random-effect meta-analysis estimated adherence. Results 22 studies were found by the inclusion criteria, which involved 1 37 699 patients with gout. Four ways to define adherence were reported. Meta-analysis revealed that the overall adherence rate was 47% (95% CI 42% to 52%, I2=99.7%). Adherence rate to ULT was 42% (95% CI 37% to 47%, I2=99.8%) for prescription claims, 71% (95% CI 63% to 79%) for pill count, 66% (95% CI 50% to 81%, I2=86.3%) for self-report and 63% (95% CI 42% to 83%, I2=82.9%) for interview, respectively. The influential factor on adherence rate was country of origin. Conclusions Among adult patients with gout, overall adherence rate to ULT was as low as 47%, which suggested that clinicians should pay more attention to medication adherence in patients with gout to effectively improve adherence to ULT.

Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: a case-control study

Abstract This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.

The impact of systemic lupus erythematosus on women's sexual functioning: A systematic review and meta-analysis

Background: A number of studies have reported the relationship between womens sexual problems and systemic lupus erythematosus (SLE). However, the results are contradictory. The objective of this paper was to explore the impact of SLE on womens sexual function. Methods: PubMed, Web of Science, CNKI Scholar, VIP and WanFang databases were searched up to April 2017. Studies evaluating the impact of SLE on womens sexual function with the use of Female Sexual Function Index (FSFI) scoring system were included. Statistical analyses were executed using version 5.0 Review Manager statistical software. Data were pooled using a fixed or random effects model according to heterogeneity. Results: A total of 2 identified studies matched the inclusion criteria, reporting on a total of 236 patients with SLE. No significant difference was observed between SLE patients and healthy controls on desire (P = .24; MD = −0.44 [−1.17, 0.29]), arousal (P = .12; MD = −0.39 [−0.89, 0.11]), lubrication (P = .17; MD = −0.53 [−1.28, 0.23]), orgasm (P = .27; MD = −0.27 [−0.75, 0.21]), satisfaction (P = .25; MD = −0.10 [−0.27, 0.07]) and pain (P = .17; MD = −0.50 [−1.22, 0.22]), except for total FSFI (P = .001; MD = −1.24 [−1.97, −0.50]). Conclusion: SLE has some influence on women’ sexual function. However, further studies of a larger population of female patients are required to further evaluate the mechanism by which SLE affects sexual function.

The impact of disease activity and psychological status on quality of life for Chinese patients with primary Sjögren’s syndrome

Objective The primary purpose of the present study was to survey the quality of life (QoL) in primary Sjögren’s syndrome (pSS) and to analyze the relationships between disease activity, anxiety/depression, fatigue, pain, age, oral disorders, impaired swallowing, sicca symptoms, and QoL. Patients and methods A survey was conducted on 185 pSS patients and 168 healthy individuals using the Short Form 36 health survey for QoL. Disease activity was assessed using the European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index. We examined these data using independent samples t-tests, Mann–Whitney U test, chi squared analysis, and linear regression. Results The result for each domain in Short Form 36 health survey was lower in pSS patients than in healthy controls, especially the score in the dimension of role physical function. In the bivariate analysis, age, pain, fatigue, disease activity, disease complication, anxiety/depression, oral disorders, and impaired swallowing correlated with QoL. Also, in the linear regression model, pain, fatigue, disease activity, impaired swallowing, and anxiety/depression remained the main predictors of QoL. Conclusion pSS patients had a considerably impaired QoL compared to the controls, and pSS could negatively affect the QoL of patients. Measuring QoL should be considered as a vital part of the comprehensive evaluation of the health status of pSS patients, which could contribute some valuable clues in improving the management of disease and treatment decisions.

The role of interleukin-4 in rheumatic diseases.

Rheumatism is a group of diseases, most of which are autoimmune diseases, that violate joints, bones, muscles, blood vessels and related soft tissue. As is well known, cytokines play a role in the pathogenesis of several rheumatic diseases, such as rheumatoid arthritis, spondyloarthritides, and systemic lupus erythematosus. Recently, the role of interleukin‐4 (IL‐4), which may participate in the mechanism of rheumatism, have been discovered. It is reported that IL‐4 takes part in the regulation of T cell activation, differentiation, proliferation, and survival of different T cell types. IL‐4 also has an immunomodulatory effect on B cells, mast cells, macrophages, and many cell types. A review of the literature on functions of IL‐4 in rheumatic diseases is presented.

The rate of adherence to urate-lowering therapy and associated factors in Chinese gout patients: a cross-sectional study

The aim of this study was to assess adherence rate and predictors of non-adherence with urate-lowering therapy (ULT) in Chinese gout patients. A cross-sectional study was administered to 125 gout patients using the Compliance Questionnaire on Rheumatology (CQR) for adherence to ULT. Patients were asked to complete the Treatment Satisfaction Questionnaire for Medication version II, Health Assessment Questionnaire, Confidence in Gout Treatment Questionnaire, Gout Knowledge Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and 36-Item Short Form Health Survey. Data were analyzed by independent sample t test, rank sum test, Chi-square analysis as well as binary stepwise logistic regression modeling. The data showed that the rate of adherence (CQR ≥80%) to ULT was 9.6% in our investigated gout patients. Adherence was associated with functional capacity, gout-related knowledge, satisfaction with medication, confidence in gout treatment and mental components summary. Multivariable analysis of binary stepwise logistic regression identified gout-related knowledge and satisfaction of effectiveness with medication was the independent risk factors of medication non-adherence. Patients unaware of gout-related knowledge, or with low satisfaction of effectiveness with medication, were more likely not to adhere to ULT. Non-adherence to ULT among gout patients is exceedingly common, particularly in patients unaware of gout-related knowledge, or with low satisfaction of effectiveness with medication. These findings could help medical personnel develop useful interventions to improve gout patients’ medication adherence.

Erratum to: Factors associated with hand joint destruction in Chinese patients with rheumatoid arthritis

* Correspondence: wxh637295@sina.com; guzf@ntu.edu.cn Equal contributors Department of Medical Image, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001 Nantong, People’s Republic of China Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001 Nantong, People’s Republic of China Full list of author information is available at the end of the article

AB0898 Sleep quality is associated with alcohol use and functional capacity in chinese patients with gout: a cross-sectional study

Background Poor sleep quality is common in patients with chronic diseases and may lead to disease aggravation and decreased quality of life. The increasing prevalence of poor sleep in individuals with chronic medical conditions is associated with adverse demographic, clinical, and psychological characteristics. However, there are currently no known reported studies related to the sleep quality of gout patients. Objectives This study aims to evaluate the prevalence of poor sleep quality and investigate the contributors of poor sleep in Chinese gout patients. Methods A self-report survey was administered to 226 gout patients and 232 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Patient Health Questionnaire (PHQ-9) for depression, and the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety. Gout patients completed the 10 cm Visual Analog Scale (VAS) for total pain, and the Health Assessment Questionnaire-Disability Index (HAQ-DI) for functional capacity. Blood samples were taken to examine the level of uric acid (UA). Independent samples t-tests, Chi square analyses, and logistic regression were used to analyze the data. Results Our results found that the prevalence of poor sleep (PSQI≥5) was 55.3% and the mean global score of PSQI was 6.69 (SD 3.48) in patients, which were significantly higher than the controls (17.7% and 3.83 (SD 1.88), respectively). There were significant correlations among alcohol use, HAQ-DI, PHQ-9, GAD-7 and sleep quality in gout patients. Patients with yellow rice wine and wine use preferred to have better sleep quality. While, disease stage was associated with hypertension, total pain, number of tophi, presence of tender joints and swollen joints. Meanwhile, logistic regression models identified alcohol use and depression as predictors of poor sleep quality. Conclusions More than half of Chinese gout population suffered from poor sleep, which significantly higher than healthy individuals. These findings suggested medical personnel should pay more attention to the sleep quality of gout patients, especially those with depression. Additionally, it is beneficial for the patients with normal UA level to take moderate yellow rice wine and wine to improve their sleep quality. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared