Depression and anxiety in systemic lupus erythematosus: A case-control study on prevalence and associated factors in a single-center cohort.

OBJECTIVES: To evaluate the prevalence of self-perceived depression and anxiety in patients with systemic lupus erythematosus (SLE) and to explore associated factors. METHODS: Cross-sectional study of unselected patients with SLE (ACR-97 criteria) and controls with chronic inflammatory rheumatic diseases. Both completed the Hospital Anxiety and Depression Scale (HADS). Demographic and clinical characteristics, comorbidity, and treatments were collected, and a multivariate analysis was performed to explore factors associated with depression and anxiety in SLE. RESULTS: The study population comprised 172 patients and 215 controls. Women accounted for 93% of the patients with SLE. Fibromyalgia was recorded in 12.8% and a history of depression in 17%. According to HADS, 37.2% fulfilled the diagnostic criteria for depression and 58.7% those for anxiety; prevalence was similar in the controls (32.6% and 55.1%, respectively). Up to a third of patients with self-perceived depression were not receiving antidepressants. There was no concordance between a previous history of depression and current depression. In the multivariate model, current depression was associated with single marital status (OR 2.69; 95% CI: 1.17-6.42; p = .022), fibromyalgia (7.69; 2.35-30.72; p = .001), smoking (3.12; 1.24-8.07; p = .016), severity of SLE (0.76; 0.6-0.94; p = .016), and organ damage (1.27; 1.01-1.61; p = .042). Current anxiety was only associated with fibromyalgia (3.97; 1.21-17.98; p = .036). CONCLUSIONS: Depression and anxiety are most likely underdiagnosed in SLE. Prevalence appears to be similar to that of other chronic inflammatory rheumatic diseases. Anxiety is associated with fibromyalgia, while depression is also associated with single marital status, smoking, organ damage, and severity of SLE.

Attention Deficit Hyperactivity Disorder in Adults With Migraine.

INTRODUCTION: Several studies have shown increased occurrence of migraine in ADHD patients. However, there is less evidence on whether migraine patients also have a higher ADHD frequency. The aim of this paper is determining whether the prevalence of ADHD symptoms or impulsivity is higher in patients with episodic migraine. METHODS: An observational cohort study has been conducted. Patients with episodic migraine were included. The ADHD Rating scale, the Adult ADHD Self-Report Scale, and the scale of impulsiveness of Plutchik were used. RESULTS: The mean value of inattention, hyperactivity and impulsivity scores on the ADHD scale was 5 ± 3.8 in cases and 2.7 ± 2.2 in controls (p < .00001), 4 ± 3.2 in cases and 2.5 ± 2.4 in controls (p = .000621) and 2 ± 1.5 in cases and 1.1 ± 1 in controls (p = .000407), respectively. CONCLUSION: Adults with migraine have a higher prevalence of ADHD symptoms. This should be considered when assessing these patients.