Quality of life in systemic lupus erythematosus patients during more and less active disease states: Differential contributors to mental and physicalhealth

Objective. To identify determinants of mental and physical health as a func tion of disease state in patients with systemic lupus erythematosus (SLE). Methods. A sample of 129 SLE patients (mean age 42.01 years; SD 11.09) was recruited from 9 immunology/rheumatology clinics across Canada. Patients co mpleted questionnaires assessing psychological distress, social support, co ping, stress, and health-related quality of life. Physicians rated disease activity (using the revised Systemic Lupus Activity Measure; SLAM-R) and da mage (using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index). Mental and physical health composit e scores were derived from the Medical Outcomes Study Short Form 36. Patien ts were subdivided into more active (SLAM-R greater than or equal to 10; n = 38) or less active disease states (n = 91). Results. Better mental health was predicted by more education and less emot ion-oriented coping in the patients in a more active disease state (P = 0.0 001; R-2 = 0.46). Better mental health was predicted by less stress, less e motion-oriented coping, and more task-oriented coping in patients during a less active disease state (P = 0.0001; R-2 = 0.45). Better physical health was predicted by more emotion-oriented coping in patients in a more active disease state (P = 0.04; R-2 = 0.11). Better physical health was predicted by less stress and younger age in patients during a less active disease sta te (P 0.0001; R-2 = 0.20). Conclusion. The positive association between emotion-oriented coping and be tter physical health in patients during a more active disease state suggest s that this style of coping may be more adaptive in situations that are con sidered uncontrollable (e.g., SLE flare). Predictors of mental health were similar to those found in the literature, especially for SLE patients in a less active disease state.