Tesis

Korelasi Ansietas dan Depresi dengan kadar C3 dan C4 serta aktivitas Lupus Eritematosus Sistemik = The Correlation Anxiety and Depression with level of C3 and C4 And Systemic Lupus Erythematosus Activity.

Latar Belakang: Ansietas dan depresi merupakan gangguan psikosomatis yang paling banyak ditemukan. Pada pasien Lupus Eritematosus, ansietas merupakan gangguan mood paling banyak ditemukan dibandingkan depresi. Selain bagian dari manifestasi NPSLE, ansietas dan depresi dapat memicu terjadinya inflamasi yang akan memengaruhi aktivitas lupus. Hospital Anxiety dan Depresi Scale (HADS) merupakan salah satu skala pengukuran ansietas dan depresi yang berbentuk kuesioner yang mudah digunakan dan sudah tervalidasi. Mexican Systemic Lupus Erythemathosus Sistemic Disease Activity (Mex SLEDAI) merupakan sistem skoring untuk pasien LES yang mudah dan lebih murah serta memiliki reliabilitas dan validitas yang baik. Saat ini belum ada yang meneliti perihal hubungan ansietas dan depresi yang menggunakan HADS dengan kadar C3 dan C4 pada pasien LES. Tujuan: Mengetahui korelasi antara ansietas dan depresi dengan kedua kadar C3 dan C4 pada pasien LES di RSCM. Metode: Penelitian ini menggunakan desain potong lintang, dilakukan analisis data primer pasien LES usia 18-60 tahun. Dilakukan wawancara dan pemeriksaan fisik serta pengisian kuesioner HADS diikuti dengan pengambilan sampel darah untuk menilai kadar C3 dan C4. Korelasi antara skor HADS ansietas dan depresi dengan kadar C3 dan C4, dan serta Mex-SLEDAI didapat dengan uji korelasi Spearman menggunakan SPSS. Hasil: Dari 120 sampel dengan median usia 31 tahun (24-37), penggunaan steroid dengan median 16 mg/minggu (0-28), dan aktivitas lupus dengan median 6 (0-11). Didapatkan korelasi antara ansietas dengan kadar C3 dan C4 yang signifikan dengan nilai r = -0,189 dan r = -0,206. Tidak didapatkan korelasi depresi dengan kadar C3 dan C4 ataupun korelasi ansietas dan depresi dengan aktivitas lupus. Kesimpulan: Terdapat korelasi negatif antara HADS ansietas dengan kadar C3 ataupun C4.
Kata Kunci: Depresi, lupus eritematosus sistemik, LES, hospital anxiety depression scale, HADS, C3 , C4, Komplemen, Mex Sledai


Background: Anxiety and depression are the most common psychosomatic disorders. Both of them have the highest prevalence of chronic diseases. In Lupus Erythematosus patients, anxiety is more common compared to depression. They have been widely penelitianed and found to have a clinical relationship. Not only they are one of the manifestations of NPSLE, they can also trigger inflammation that will affect lupus activity. On the other hand, many patients with anxiety and depression are undiagnosed and treated inappropriately. There is a screening tool that can measure both disorders quantitatively, namely the Hospital Anxiety and Depression Scale (HADS). Mexican Systemic Lupus Erythematosus Systemic Disease Activity (Mex-SLEDAI) can also be used to measure lupus activity. The advantage of this scoring is that it can be tested without measuring complement or anti-dsDNA levels, which is not necessarily available in every hospital. One of the factors that affects the activity of lupus is complement activity. Currently, no one has investigated the relationship between anxiety and depression using HADS with levels of C3 and C4 in SLE patients. Objective: To determine the correlation between anxiety and depression with levels of C3 and C4 in SLE patients in RSCM. Methods: This study used a cross-sectional design, analyzed the primary data of SLE patients aged 18-60 years. Interviews and physical examinations were carried out as well as filling out the HADS questionnaire followed by taking blood samples to assess C3 and C4 levels. The correlation between HADS scores of anxiety and depression with levels of C3 and C4, and Mex-SLEDAI was obtained using the Spearman correlation test using SPSS. Results: 120 samples with a median age of 31 years (24-37), with the use of steroid doses with a median of 16 mg/week (0-28) and lupus activity with a median of 6 (0-11), there was a correlation between anxiety HADS and C3 levels and C4 which is significant with a value of r = -0.189 and r = -0.206. However, for HADS Depression with levels of C3 or C4 no correlation was found. In addition, in this study, there was no correlation between HADS Anxiety and Depression with Lupus Mex Sledai activity Conclusion: There was a negative correlation between HADS Anxiety and levels of C3 or C4.
Keywords: Depression, systemic lupus erythematosus, SLE, hospital anxiety depression scale, HADS, C3, C4, Complement, Mex-SLEDAI