Perceived Stress Independently Predicts Worse Disease Activity and Symptoms in a Multi-Racial/Ethnic Systemic Lupus Cohort

Details

• Alternative Title:
  Arthritis Care Res (Hoboken)
• Personal Author:
  Patterson, Sarah ; Trupin, Laura ; Hartogensis, Wendy ; DeQuattro, Kimberly ; Lanata, Cristina ; Gordon, Caroline ; Barbour, Kamil E. ; Greenlund, Kurt J. ; Dall’Era, Maria ; Yazdany, Jinoos ; Katz, Patricia
• Description:
  Objective:
  
  Studies have suggested a potential link between traumatic experiences, psychological stress, and autoimmunity, but the impact of stress on disease activity and symptom severity in systemic lupus erythematosus (SLE) remains unclear. We examined whether increases in perceived stress independently associate with worse SLE disease outcomes over three years of follow-up.
  
  Methods:
  
  Participants were drawn from the California Lupus Epidemiology Study (CLUES). Stress was measured annually using the 4-item Perceived Stress Scale (PSS). Participants with PSS increases ≥0.5 standard deviation were defined as having an increase in stress. Four outcomes were measured at the year 3 follow-up visit: physician-assessed disease activity (Systemic Lupus Disease Activity Index), patient-reported disease activity (Systemic Lupus Activity Questionnaire), pain (PROMIS Pain Interference), and fatigue (PROMIS Fatigue). Multivariable linear regression evaluated longitudinal associations of increase in stress with all four outcomes while controlling for potential confounders.
  
  Results:
  
  The sample (n=260) was 91% female, 36% Asian, 30% White, 22% Hispanic, and 11% African American; mean age 46 (±14) years. In adjusted longitudinal analyses, increase in stress independently associated with greater physician-assessed disease activity (p=0.015), greater self-reported disease activity (p<0.001), more pain (p=0.019), and more fatigue (p<0.001).
  
  Conclusion:
  
  In a racially diverse sample of persons with SLE, those who experienced an increase in stress had significantly worse disease activity and greater symptom burden at follow-up compared to those with stress levels that remained stable or declined. Findings underscore the need for interventions to bolster stress resilience and support effective coping strategies among individuals living with lupus.
  
  
• Subjects:
  Adult Fatigue Female Humans Lupus Erythematosus, Systemic Male Middle Aged Pain Racial Groups Severity Of Illness Index Stress, Psychological

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• Source:
  Arthritis Care Res (Hoboken). 75(8):1681-1689
• Pubmed ID:
  36537191
• Pubmed Central ID:
  PMC10279800
• Document Type:
  Journal Article
• Funding:
  U01 DP006486/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP006701/DP/NCCDPHP CDC HHSUnited States/ ; P30 AR070155/AR/NIAMS NIH HHSUnited States/ ; K23 AT011768/AT/NCCIH NIH HHSUnited States/
• Volume:
  75
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:4f290e4738c98f0fa394c33d88eac0bd7c24a572c66b72aedfa3394d4de44660daeddac6a772c58b7a6a16b36e7cd6d10d0ade66c7ac03fa6ca72d4b7bd904d9
• Download URL:
  https://stacks.cdc.gov/view/cdc/129973/cdc_129973_DS1.pdf
• File Type:
  [PDF - 241.96 KB ]