Effect of Stress on Disease Activity among Systemic Lupus Erythematosus Patients: A Descriptive Cross-Sectional Study

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that cause multisystemic inflammation and tissue damage. Little research focuses on the impact of stress on SLE disease activity, particularly among ethnic populations with restricted resources.

Objectives: A cross-sectional study examines the effect of stress on disease activity. Study the link between stress and disease activity and investigates the relationship between demographic factors, stress, and SLE disease activity. Examines which demographic features affect these study variables.

Methods: Stress levels were assessed using the Perceived Stress Scale (PSS-14), while disease activity was measured using SLEDAI-24 scores. Spearman’s correlation analyzed links between stress, demographic factors, and clinical indicators. Linear regression evaluated the impact of stress on disease activity. Alcohol use was omitted due to lack of data. Statistical significance was set at p < 0.05.

Results: The study included 85.7% female participants averaging 32.96 ± 8.25 years in age. High stress levels were reported by 69.5% of participants (PSS-14: 33.10 ± 8.99), driven by emotional exhaustion and loss of control. Smoking correlated with increased stress (r = 0.198, p = 0.043), while psychotropic medication reduced inflammation (r = -0.236, p = 0.015). Severe disease activity was observed in 91.4% of patients (SLEDAI: 30.40 ± 11.96). Stress accounted for 4.1% of disease variations. Data analysis showed a positive correlation between stress and SLE disease activity with a value of r = 0.193 at p = 0.038.

Conclusion: Stress greatly increases SLE disease activity in Iraqi patients with socioeconomic factors like smoking and low income contributing to increased risk. Psychotropic drugs reduce inflammation, which emphasizes the importance of include mental health and socioeconomic assistance into SLE care plans.