Background Little is known about depression in SLE. To evaluate the prevalence of depression and associated factors in a large, multicenter SLE cohort (RELESSER-PROS).

Methods Prospective longitudinal study of SLE patients answering positively to the depression question of the Lupus Impact Tracker (LIT) questionary (question number 7, LITQ7 ‘I was depressed’) over 5 consecutive annual visits (V1 to V5). Self-perceived depression was answered from 0 (‘none of the time’) to 4 (‘most of time’). Covariates with potential impact in depression were considered. Friedman test and GEE models were used.

Results 1463 patients were included. Mean age 55 years, 90% female. Mean disease duration: 14 years. Fibromyalgia was present in 5.7%. Glucocorticoids use ranged from 49.4% to 57%, depending on the visit. SLEDAI ranged from 0 to 2 and SDI from 1 to 2. Prevalence of ‘depression any time’ was 89.9% and ‘most of time’ in 34.6%. Up to 26.5% answered to LITQ7 ‘depression most of time’ in the five visits. 89.7% perceived themselves as depressed at least in 2 out of 5 visits. Only 6.9% of the patients with previous diagnosis of depression answered ‘0’ (‘none of the time’) to LITQ7. SLEDAI, SDI, Charlson and glucocorticoids use showed statistically significative changes during the follow up. Patients with ‘depression any time’ developed more damage at V5 than patients without depression (p=0.009). In the GEE binomial analysis, fibromyalgia (OR 2.79), unemployment (OR 1.95) and glucocorticoids use (OR 1.88) were significantly associated with ‘depression any time’. The best model displayed a significant association with fibromyalgia (OR 2.90) and glucocorticoids (OR 1.85). Neither SDI nor unemployment reached significance (table 1). Without entering glucocorticoids, SLEDAI turns significant in the model, suggesting collinearity.

Conclusions The prevalence of self-perceived depression is high in SLE. Our study suggests causal relationship between glucocorticoids use, fibromyalgia and self-perceived depression.