The Association of Illness Uncertainty and Hope With Depression and Anxiety Symptoms in Women With Systemic Lupus Erythematosus: A Cross-sectional Study of Psychological Distress in Systemic Lupus Erythematosus Women


Depression and anxiety are commonly observed psychological symptoms in patients diagnosed with systemic lupus erythematosus (SLE). This study aimed to explore the possible factors that influence depression and anxiety symptoms development in SLE women.


This cross-sectional study was conducted between October 2017 and December 2018 in Liaoning, China. Questionnaires including Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Mishel Uncertainty in Illness Scale for Adults, and Herth Hope Scale were completed by 205 participants. Factors related to depression and anxiety were examined using hierarchical multiple regression analysis, while the effect of hope was examined using structural equation model.


The prevalence of depression and anxiety symptoms in female SLE patients was 79.5% and 86.8%, respectively. Illness uncertainty was strongly positively correlated with depression and anxiety symptoms. In contrast, hope was negatively associated with depression and anxiety symptoms. Up to 66.6% and 59.4% of the variance explained by all the variables was 66.6% in depression symptoms and 59.4% in anxiety symptoms. Interestingly, hope was able to alter the relationship of illness uncertainty with depression and anxiety symptoms.


While illness uncertainty can increase depression and anxiety symptoms, hope can reduce these symptoms. Therefore, hope-based targeted interventions should be employed to prevent and treat depression and anxiety symptoms among SLE women.