Association Between Stressful Life Events and Female Primary Sjogren's Syndrome and Their Role in Disease Activity: A Retrospective Case-Control Study in China

Abstract

Purpose: Previous evidence has shown that psychological stress can trigger the onset of autoimmune disease. This study aimed to investigate the prevalence of stressful life events preceding the onset of symptoms in female primary Sjogren's syndrome (pSS) in China compared to controls and the possible associations of stressful life events with disease activity.

Patients and methods: This was a hospital-based retrospective case-control study. Sixty-seven consecutive female pSS patients and an equal number of age-matched (± 3 years) healthy controls were recruited for assessment using the related Stressful Life Events Scale. The pSS disease activity was measured by the EULAR Sjogren's syndrome disease activity index. Data were analyzed by SPSS, version 23, using chi-square, univariate logistic regression, multiple logistic regression, and partial correlation.

Results: A higher number of negative stressful life events before disease onset in pSS patients compared with healthy controls suggest that these play a role in increasing the risk of disease occurrence (OR = 2.59, 95% CI: 1.87-3.58, p < 0.05). The number of positive life events did not differ between the two groups. Both the number and severity of the negative stressful life events were also significantly correlated with disease activity.

Conclusion: Patients with pSS experienced more negative stressful life events in the year preceding the onset of symptoms than controls. Negative stressful life events before symptom onset may be risk factors for pSS and may affect pSS disease activity.

Keywords: primary Sjogren’s syndrome; retrospective case-control study; risk factors; stressful life events.