. 2018 Sep 12;75(12):1225–1233. doi: 10.1001/jamapsychiatry.2018.2462

Table 3. Association of History of Depressive Symptoms, Self-reported Physician Diagnosis of Depression, and Antidepressant Use With Incident SLE in the NHS and NHS II, 1992-2013.

Variable	SLE Cases, No.	Person-Years^a	Hazard Ratio (95% CI)
Variable	SLE Cases, No.	Person-Years^a	Model 1^b	Model 2^c
Depressive symptoms (MHI-5)
No depression (MHI-5 score ≥60)	99	2 793 212	1 [Reference]	1 [Reference]
Probable depression (MHI-5 score <60)	43	694 391	1.70 (1.18-2.44)^d	1.60 (1.11-2.31)^e
Diagnosis of depression
No diagnosis	59	2 148 617	1 [Reference]	1 [Reference]
Diagnosis	20	366 539	2.19 (1.29-3.71)^d	1.91 (1.12-3.26)^e
Antidepressant use
No use	93	2 703 408	1 [Reference]	1 [Reference]
Use	40	431 991	2.80 (1.94-4.05)^f	2.47 (1.70-3.60)^f
Sensitivity analysis 1, depressive symptoms with more stringent MHI-5 cutoff
No depression (MHI-5 score ≥52)	117	3 175 548	1 [Reference]	1 [Reference]
Probable depression (MHI-5 score <52)	22	219 142	2.29 (1.45-3.64)^d	2.17 (1.37-3.46)^d
Sensitivity analysis 2, censoring women at first antidepressant use
No depression	61	2 184 815	1 [Reference]	1 [Reference]
Depression diagnosis or MHI-5 score <60	26	452 061	2.11 (1.32-3.38)^d	2.04 (1.27-3.26)^d
Sensitivity analysis 3, association with antidepressant type
No antidepressant use	93	2 704 188	1 [Reference]	1 [Reference]
SSRI use	26	289 937	2.96 (1.88-4.64)^f	2.63 (1.66-4.14)^f
Tricyclic or other antidepressant use	12	118 695	3.19 (1.72-5.93)^f	2.86 (1.53-5.31)^f
Sensitivity analysis 4, stratified by dsDNA antibody status
Anti-dsDNA antibody–positive SLE
No depression	33	2 529 872	1 [Reference]	1 [Reference]
Depression	42	1 140 243	2.58 (1.66-3.99)^f	2.28 (1.46-3.56)^f
Anti-dsDNA antibody–negative SLE
No depression	36	2 529 748	1 [Reference]	1 [Reference]
Depression	34	1 140 158	2.50 (1.54-4.06)^f	2.30 (1.41-3.75)^f

Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); dsDNA, double-stranded DNA; MHI-5, 5-item Mental Health Inventory; NHS, Nurses’ Health Study; SLE, systemic lupus erythematosus; SSRI, serotonin reuptake inhibitor.

^{^a}

Person-years differ in models because each measure was first queried in a different year; person-time prior to the first query was excluded.

^{^b}

Adjusted for race and age.

^{^c}

Adjusted for time-updated BMI, cigarette smoking, and oral contraceptive and postmenopausal hormone use.

^{^d}

P < .01.

^{^e}

P < .05.

^{^f}

P < .001.