Takeaway
- Women with a history of depression may have a >2-fold risk of developing systemic lupus erythematosus (SLE).
Why this matters
- Findings add to a growing body of evidence linking depression and SLE.
- Treatment for depression may cut the risk for SLE.
Study design
- Nested case-control within 2 prospective cohorts (n=194,483) consisting of the Nurses' Health Study (NHS) (1996-2012) and the NHSII (1993-2013).
- History of depression was defined by antidepressant use, clinician diagnosis of depression, or "probable depression" score on the 5-item Mental Health Inventory.
- SLE was defined by self-report of ≥4 American College of Rheumatology criteria and was confirmed by medical record review.
- Funding: National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Key results
- 145 cases of SLE were identified over 20-year follow-up.
- Women with a history of depression were at increased risk for SLE vs women with no history (HR, 2.67; P<.001>
- The association was only slightly attenuated (adjusted HR, 2.45; P<.001 by adjusting for bmi cigarette smoking oral contraception and postmenopausal hormone use.>
Limitations
- Nurses were healthier than the general population and were mostly white, thereby limiting generalizability.
- Potential for misclassification of depression history.
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