[Stress and coping strategies in systemic lupus erythematosus]

UNDENIABLE PSYCHOLOGICAL IMPACT: Systemic lupus erythematosus (SLE), a chronic and unpredictable disease with functional disability and with a possible involvement of the central nervous system, leads to severe psychological distress. THE ROLE OF STRESS AND COPING: Many studies have investigated the place of major and minor stress and coping strategies in SLE morbidity (activity, organ damage, and physical and mental component of quality of life). Stress as a provoking factor is not proved, but stress seems to act as an exacerbating factor in the activity and to have an impact on quality of life. Coping strategies are more consistently associated with quality of life than activity. Organ damage appears to be less associated with psychosocial factors than activity or quality of life. THE NEED FOR ACTION: Despite the limitations of these studies, therapeutic interventions have to be proposed to reduce psychological distress, to improve quality of life, and maybe to moderate the progression of the disease.