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Socioeconomic Predictors of Incident Depression in Systemic Lupus Erythematosus
Author(s) -
Mccormick Natalie,
Trupin Laura,
Yelin Edward H.,
Katz Patricia P.
Publication year - 2018
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23247
Subject(s) - medicine , depression (economics) , socioeconomic status , confidence interval , demography , odds ratio , gee , gerontology , generalized estimating equation , population , environmental health , sociology , economics , macroeconomics , statistics , mathematics
Objective To assess different measures of socioeconomic status ( SES ) as predictors of incident depression among women with systemic lupus erythematosus ( SLE ). Methods Data were derived from the 2010–2015 waves of the Lupus Outcomes Study, where individuals with confirmed SLE were interviewed annually by telephone. Depression was assessed using the Center for Epidemiologic Studies Depression Scale, using a validated lupus‐specific cutoff (≥23) for major depressive disorder. Women interviewed in ≥2 consecutive waves, with scores <23 in the first wave (T1), were included. The level of financial strain was classified as high, moderate, or none based on responses to 3 questions. Generalized estimating equations were used to assess the impact of poverty status, income, education, and financial strain at T1 on the risk of incident depression the next year (T2), with adjustment for sociodemographic and disease status measures. Individuals could contribute more than one 2‐year dyad to the analysis. Results In total, 682 women contributed 2,097 observations, with 19% having high financial strain, 47% moderate strain, and 34% no strain. There were 166 women who had 184 episodes of incident depression (rate = 8.8/100 person‐years). In bivariate analysis, poverty, lower income and education, disease activity, and high financial strain were associated with depression onset; race/ethnicity was not. Poverty, income, and education were not significant in multivariate analyses, but disease activity and high financial strain were (odds ratio 1.85 [95% confidence interval 1.06–3.23]). Conclusion High financial strain was a significant predictor of new‐onset depression in women with SLE , controlling for disease factors and other SES measures. Determining specific, modifiable sources of financial strain may help prevent the development of depression.