Association of Self-Reported Depression on the Lupus Impact Tracker with Glucocorticoid Therapy and Fibromyalgia in Systemic Lupus Erythematosus: Insights from the RELESSER-PROS Registry

By
Inigo Rua-Figueroa
Julia Martínez-Barrio
Zulema Plaza
Norman Jiménez
Maria Galindo-Izquierdo
Esther Uriarte
Antonio Fernandez-Nebro
Jaime Calvo Alen
José Rosas
Javier Narváez
Elena Aurrecoechea
Mercedes Freire
Eva Tomero
Clara Sanguesa
Carlota Iniguez
Ana Perez
Sandra Garrote
Nuria Lozano-Rivas
Oihane Ibarguengoitia
Eva Salgado
Celia Erausquin
Tarek Carlos Salman Monte
Raúl Menor
Irene Altabás-González
Jorge Fragio Gil
Joan M. Nolla
Jose M. Pego-Reigosa
January 24, 2026
0 min

Bmc Rheumatology

Overview

In a large prospective cohort of systemic lupus erythematosus (SLE) patients, nearly 90% reported depressive symptoms at some point, with over one-third experiencing depression most of the time. Longitudinal analysis revealed significant associations between self-reported depression and glucocorticoid therapy as well as fibromyalgia.

Background

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse manifestations that can cause irreversible organ damage. Depression is a common neuropsychiatric manifestation in SLE, adversely affecting quality of life and clinical outcomes. The Lupus Impact Tracker (LIT) is a validated patient-reported outcome measure that includes an item assessing mood disturbance, providing a practical tool to capture patient-perceived depression. Understanding factors associated with depression in SLE may guide better management strategies.

Data Highlights

Measure	Value
Number of patients	1,463
Mean age (years)	55 ± 13.6
Female (%)	90%
Median disease duration (years)	14 (IQR 7.4–18.9)
Fibromyalgia prevalence (%)	5.7%
Glucocorticoid use (%)	49.4%–57% across visits
Prevalence of depression any time (%)	89.9%
Prevalence of depression most of the time (%)	34.6%
Persistent depression (all visits, %)	26.5%

Key Findings

89.9% of patients reported depressive symptoms at least some of the time during follow-up.
34.6% reported being depressed most of the time, with 26.5% persistently depressed across all visits.
Glucocorticoid therapy was significantly associated with higher odds of self-reported depression over time.
Fibromyalgia presence correlated with increased self-reported depressive symptoms longitudinally.
Patients reporting depression developed significantly greater organ damage by the final visit.
Self-reported depression aligned well with prior formal depression diagnoses, supporting LITQ7 validity.

Clinical Implications

Clinicians should be vigilant for depressive symptoms in SLE patients, especially those receiving glucocorticoids or diagnosed with fibromyalgia. Regular use of patient-reported outcome tools like the Lupus Impact Tracker can facilitate early identification and monitoring of mood disturbances. Addressing depression may improve adherence, quality of life, and potentially reduce organ damage progression.

Conclusion

Self-reported depression is highly prevalent and persistent in SLE, with glucocorticoid use and fibromyalgia as key associated factors. Incorporating patient-centered assessments can enhance comprehensive care in this complex disease.

References

RELESSER-PROS Registry Study 2024 -- Association of Self-Reported Depression on the Lupus Impact Tracker with Glucocorticoid Therapy and Fibromyalgia in Systemic Lupus Erythematosus