ArticleArthritis care & research2023
Perceived Stress and Prediction of Worse Disease Activity and Symptoms in a Multiracial, Multiethnic Systemic Lupus Erythematosus Cohort.
Article in Arthritis care & research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Stress and the Immune System: Insights From Psychoneuroimmunology.Physiological research · 2026Review
- Stress exposure prior to diagnosis and clinical characteristics in systemic lupus erythematosus: a cross-sectional study.Rheumatology international · 2026Article
- Sex Differences in PROMIS Pediatric Depressive Symptoms, Anxiety, and Psychological Stress Among Children and Adolescents Living With Pediatric Rheumatic Diseases.The Journal of rheumatology · 2026Article
- The Effect of Everyday Discrimination on Systemic Lupus Erythematosus Disease Activity and Mental Health Outcomes.The Journal of rheumatology · 2026Article
- Environmental and occupational contributors to autoimmune, inflammatory, and musculoskeletal rheumatic disease: a review of emerging evidence and clinical implications.Current opinion in rheumatology · 2026Review
- Allostatic Load Mediates Associations Between Race and Ethnicity and Hypertensive Disorders of Pregnancy.Obstetrics and gynecology · 2026Article
- Article
- Perceived Stress and Prediction of Worse Patient-Reported Outcomes in a Rheumatoid Arthritis Cohort.Arthritis care & research · 2025Article
- Medical Post-Traumatic Stress Disorder Symptoms in Children and Adolescents with Chronic Inflammatory Arthritis: Prevalence and Associated Factors.Children (Basel, Switzerland) · 2025Article
- Article
- Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history.Lupus science & medicine · 2024Article
- Implications of Inflammatory Processes on a Developing Central Nervous System in Childhood-Onset Systemic Lupus Erythematosus.Arthritis & rheumatology (Hoboken, N.J.) · 2024Review
- The association of trauma with self-reported flares and disease activity in systemic lupus erythematosus (SLE).Rheumatology (Oxford, England) · 2023Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveStudies have suggested a potential link between traumatic experiences, psychological stress, and autoimmunity, but the impact of stress on disease activity and symptom severity in systemic lupus erythematosus (SLE) remains unclear. The present study was undertaken to examine whether increases in perceived stress independently associate with worse SLE disease outcomes over 3 years of follow-up.
methodsParticipants were drawn from the California Lupus Epidemiology Study (CLUES). Stress was measured annually using the 4-item Perceived Stress Scale (PSS). Participants with increases of ≥0.5 SD in PSS score were defined as having an increase in stress. Four outcomes were measured at the year 3 follow-up visit: physician-assessed disease activity (Systemic Lupus Erythematosus Disease Activity Index); patient-reported disease activity (Systemic Lupus Activity Questionnaire); pain (Patient-Reported Outcomes Measurement Information System [PROMIS] pain interference scale); and fatigue (PROMIS fatigue scale). Multivariable linear regression evaluated longitudinal associations of increase in stress with all 4 outcomes while controlling for potential confounders.
resultsThe sample (n = 260) was 91% female, 36% Asian, 30% White, 22% Hispanic, and 11% African American; the mean ± SD age was 46 ± 14 years. In adjusted longitudinal analyses, increase in stress was independently associated with greater physician-assessed disease activity (P = 0.015), greater self-reported disease activity (P < 0.001), more pain (P = 0.019), and more fatigue (P < 0.001).
conclusionIn a racially diverse sample of individuals with SLE, those who experienced an increase in stress had significantly worse disease activity and greater symptom burden at follow-up compared to those with stress levels that remained stable or declined. Findings underscore the need for interventions to bolster stress resilience and support effective coping strategies among individuals living with lupus.
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