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Time perspective predicts the progression of permanent organ damage in patients with systemic lupus erythematosus

Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA

T M Bush

Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA

C M Neuwelt

Department of Medicine, Alameda County Medical Center, Oakland, CA, USA

M M Ward

VA Palo Alto Health Care System, and the Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA, wardm1{at}mail.nih.gov

Patients whose perspectiveis oriented to the future more than to the present may have better long-term health outcomes. We examined if time perspective predicted future organ damage in patients with systemic lupus erythematosus(SLE). We assessed the time perspectivesof 87 patients with SLE using a questionnaire at a baseline visit. Permanent organ damage was assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index during the same visit, and reassessed after a median of 4.6 years. Patients who were oriented more to the futurewere less likely to have an increasein the Damage Index than those oriented more to the present. In a multivariate analysis, each 1-point increase in the degree of orientation to the future (on a scale of 1-6) was associatedwith a 22% decreasein the likelihood that the Damage Index would increase over time (odds ratio 0.78; 95% confidence interval 0.64-0.94; P 0.009). Other measures that predicted an increase in the Damage Index were lower education levels, greater health locus of control attributed to chance and greater health locus of control attributed to powerful others. In conclusion, time perspective is a significant predictor of future organ damage in SLE. Patients who have a greater orientation to the future are less likely to develop permanent organ damage.

Key Words: organ damage • socioeconomic status • systemic lupus erythematosus • time perspective

Lupus, Vol. 12, No. 6, 443-448 (2003)
DOI: 10.1191/0961203303lu410oa


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