Confidence in medical care linked to depression in lupus sufferers.

OBJECTIVE: This cross-sectional study was performed to provide a preliminary investigation of the relationship between patient satisfaction with medical care and depression among individuals diagnosed with lupus. METHOD: A mail-out questionnaire was completed by 154 members of the Lupus Australia Foundation and the Lupus Association of New South Wales. Each questionnaire consisted of the Lupus Medical and Symptoms Questionnaire, Patient Satisfaction Questionnaire-Third Edition, and Cardiac Depression Scale. RESULTS: Participants reported, on average, a moderate level of illness severity and pain associated with lupus. The majority of participants reported moderate to severe depression and a moderate level of satisfaction with medical care. Hierarchical regression analysis revealed that 40% of the variance in depression scores could be explained by negative illness factors and dissatisfaction with medical care. In particular, depression was associated with the technical quality of medical care, pain levels, and perceived severity of illness. CONCLUSION: This research identified that patient confidence in the competency of the medical practitioner was an important factor in the experience of depression. These findings indicate the need for both medical practitioners and mental health professionals to acknowledge the interrelationship between medical and psychological factors in patients with chronic illnesses such as lupus.

Relationship of illness perceptions with depression among individuals diagnosed with lupus.

BACKGROUND: The purpose of this study was to investigate the relationship of illness perceptions, as outlined in the Self-Regulatory Model of illness, with depression among individuals diagnosed with lupus. METHODS: A mail-out questionnaire was completed by 154 members of the Australia Lupus Foundation and Lupus Foundation of New South Wales. Each questionnaire consisted of a Lupus Medical and Symptoms Questionnaire, the Illness Perceptions Questionnaire-Revised and the Cardiac Depression Scale. RESULTS: Hierarchical regression analysis revealed that individuals who reported a perception of their illness as having negative life consequences, an unpredictable nature and themselves possessing little understanding of lupus, reported high levels of depression. CONCLUSIONS: This study indicated the existence of a high level of depressive symptoms among individuals diagnosed with lupus, and reinforces the need for screening procedures in chronic illness, and treatment interventions that target maladaptive illness perceptions.

Self-reported sleep in systemic lupus erythematosus.

The objectives of the study were to assess sleep disturbances in systemic lupus erythematosus (SLE) and to compare these with a working sample and a treatment-seeking sample reporting insomnia. The primary sample was 172 people with SLE. This sample represented 32% of all members of two lupus support association. Two comparison samples were used: 223 adults who expressed interest in taking part in a psychological treatment for sleep problems and 456 Australian adults who were working at a large organization. All individuals completed the Pittsburgh Sleep Quality Index (PSQI; 6). Data derived from the PSQI included total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency, as well as the global and seven component scores. The SLE sample reported significantly worse sleep on all parameters than the working sample, but significantly better sleep than the sample of those seeking treatment for sleep disorders, except for sleep onset latency. The percentages scoring >5 on the PSQI global score was 80.5% for SLE, 91.5% for those seeking treatment for sleep disorders, and 28.5% for the working sample. PSQI component scores for the SLE group more closely resembled those of the treatment-seeking group. Self-reported sleep in this sample of people with SLE was significantly better on most parameters than that of a group seeking treatment for sleep disorders. However, the values obtained tended to be worse than previous reports and indicated less than optimal sleep. However, the low response rate of the sample was of concern and may indicate that the sample was biased. The present results suggest that sleep disturbance is common in those with SLE and deserves more attention in a more representative sample.

Depression and pain in night time and daytime functioning of individuals with lupus.

The purpose of this study was to investigate the role of pain and depression in night time and daytime functioning of individuals with lupus. A cross-sectional research design was used. Participants were recruited via a mail-out to members of the Lupus Australia Foundation and the Lupus Association of New South Wales. One hundred and fifty-four participants completed a questionnaire package consisting of a Lupus Medical and Symptoms Questionnaire designed by the researchers, the Cardiac Depression Scale and the Pittsburgh Sleep Quality Index. Hierarchical regression analyses revealed that pain principally predicted levels of sleep disturbance, whilst depression and pain (to a lesser extent) together predicted daytime dysfunction. The present results suggested the need for more adequate pain management, particularly at night and psychological interventions to decrease levels of depression that interfere with daily functioning in individuals with lupus.