Coping styles and depression in patients with systemic lupus erythematosusand rheumatoid arthritis

Study objectives. Systemic lupus erythematosus (SLE) and rheumatoid arthrit is (RA) are chronic auto-immune rheumatic diseases associated with higher r ates of depression than occur in the general population. The objectives of this study were to examine the extent of depression in a South African samp le of patients with SLE and RA, and to examine the role of coping styles, l ife stress, disease activity and demographic variables in predicting depres sion Subjects and Methods. The subjects consisted of 51 consecutive SLE and 19 c onsecutive RA patients attending the rheumatology clinic at Tygerberg Hospi tal, Care Town. Depression was measured by the Zung Self-Rating Scale for D epression, coping styles by the Medical Coping Modes Questionnaire, life st ress by the Life Event Scale, and disease activity by the Lupus Activity Cr iteria Count. Results. Depression was present in 35% of the SLE patients and in 32% of th e RA patients. Because SLE and RA patients did not differ significantly wit h regard to depression scores, the two groups were combined for statistical purposes. Multiple regression analysis indicated that an acceptance-resign ation coping mode and high life stress were significant independent predict ors of depression. Conclusions. The results imply that psychotherapeutic assistance to cope wi th stress can enhance the quality of life of patients with auto-immune rheu matic disease. Interventions aimed at changing a passive, acceptant mode of coping with their illness to a more active, problem-solving coping mode co uld have a beneficial effect on depressive symptoms in these patients.