Post-traumatic stress disorder in patients with systemic lupus erythematosus heavily affects quality of life. A cross-sectional web survey-based study.

OBJECTIVES: Neuropsychiatric symptoms develop in up to 20% of the patients with Systemic Lupus Erythematosus (SLE). Growing evidence is accruing on the association of SLE with Post-traumatic Stress Disorder (PTSD), but little is known about its contribution on patient-reported outcomes. This study focuses on PTSD prevalence in our SLE cohort and on its impact on quality of life. METHODS: Trauma and Loss Spectrum - Self Reported (TALS-SR) and Lupus Quality of Life (Lupus QoL) questionnaires were administered via web to the patients with SLE in our cohort, along with questions on demographical and disease-related aspects. RESULTS: Among 99 patients who completed the questionnaire, fatigue prevalence was 75% and 31% scored TALS-SR test consistently with PTSD. Patients with PTSD achieved lower scores compared to those without PTSD in three Lupus QoL domains: planning (83.3 vs. 100, p = .035), body image (85.0 vs. 95.0, p = .031) and fatigue (66.7 vs. 91.7, p = .001). An inverse correlation was found between TALS-SR domains and Lupus QoL scores, particularly regarding fatigue with reaction to losses or upsetting events (ρ -0.458, p < .001). CONCLUSIONS: PTSD is possibly far more frequent in patients with SLE than in general population and exerts a detrimental influence on quality of life.

Interactions between Severe Allergy and Anxiety in Anti-SARS-CoV-2 Vaccinees.

Severe drug allergy affects patient hesitancy to new treatments, posing unprecedented challenges to anti-SARS-CoV-2 vaccination campaigns. We aimed to analyze the psychological profile of vaccinees with a history of severe allergy in comparison to subjects with a milder allergy history. Patients attending a dedicated vaccination setting were administered an anonymized questionnaire including clinical data and the State-Trait Anxiety Inventory (STAI) scale (score range 20−80). Patients were also asked whether being in a protected setting affected their attitude toward vaccination. Data are expressed as median (interquartile range). We enrolled 116 patients (78% women), of whom 79% had a history of drug anaphylaxis. The median state anxiety score was 36.5 (30−47.2), while the trait anxiety score was 37 (32−48). State anxiety was higher in those with severe than mild allergy [39 (32−50) vs. 30 (25−37); p < 0.001], with the highest score found in a patient with previous drug anaphylaxis (42.5 [32−51.7]). More than 50% of patients reported that being in a protected setting had lowered their anxiety. Severe allergy is associated with a higher burden of situational anxiety in the setting of vaccination without affecting patient constitutional (trait) levels of anxiety. Vaccination in dedicated facilities might overcome issues related to hesitancy and improve patients' quality of life.