Abstract
Objectives Systemic lupus erythematosus (SLE) can significantly influence patients’ quality of life and subjective wellbeing (SWB). This study compared SWB statuses in SLE patients and analysed their relationship with clinical manifestations, emotional variables and related positive factors.
Methods Overall, 1779 SLE patients from the Chinese SLE Treatment and Research Group (CSTAR) and 203 age and gender-matched individuals from the general population without self-reported SLE were invited to complete measures of SWB, emotional variables and related positive factors. These patients’ clinical data in CSTAR were also linked to investigate the influence of clinical manifestations and psychological factors on SWB among SLE patients.
Results SWB, self-efficacy and resilience were significantly lower (P<0.001) in SLE patients than in the general population, and self-esteem, depression and anxiety were significantly higher (P<0.001). Among the SLE patients, life satisfaction was significantly positively correlated with patients’ age (P<0.001) and the age at diagnosis (P<0.001) and negatively correlated with SLE disease activity index (SLEDAI) (P<0.05). Premature gonadal failure (PGF) (P<0.05) was significantly associated with positive and negative affect scores. In active SLE patients with SLEDAI≥4, depression and resilience were life satisfaction predictors. However, anxiety, self-esteem and resilience predicted life satisfaction changes in in patients with SLEDAI<4.
Conclusion SWB provides useful insight into the impact of SLE on mental health and opportunities to improve quality of life and clinical care. PGF and disease activity emerge as are predictors of SWB status and potential therapeutic targets to develop positive attitude in SLE patients.
