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In 56 SLE patients we assessed disease activity (SLEDAI), functional limitations (HAQ), psychological distress (SCL-90-R), defence styles (Defence Style Questionnaire), hostility (HDHQ), coping with health-stressors (Sense of Coherence scale) and HRQOL (WHOQOL-BREF). Two hundred and eight rheumatologic patients (168 with rheumatoid arthritis [RA] and 40 with primary Sj\u00f6gren\u2019s syndrome [SS]) served as disease controls. SLE patients\u2019 HRQOL was similar to that of patients with RA and primary SS after adjusting for demographic and disease variables. Psychological distress was significantly associated with most aspects of HRQOL, but sense of coherence mediated the relationship of psychological distress with Physical HRQOL; this mediation effect was unique to SLE, as mediation analyses showed. Maladaptive action defence style was also significantly associated with Environment HRQOL independently of psychological distress ( p\u2009&lt;\u20090.024). These findings indicate that, apart from the early assessment and treatment of psychological distress, clinicians and consultation\u2013liaison psychiatrists should bear in mind the SLE patients\u2019 psychological resources and coping capacities to deal with the stress of the disease, since such traits, although usually underestimated, are strongly independently associated with HRQOL.<\/jats:p>","DOI":"10.1177\/0961203311398264","type":"journal-article","created":{"date-parts":[[2011,5,11]],"date-time":"2011-05-11T23:50:34Z","timestamp":1305157834000},"page":"893-903","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Coping with health-stressors and defence styles associated with health-related quality of life in patients with systemic lupus erythematosus"],"prefix":"10.1177","volume":"20","author":[{"given":"T","family":"Hyphantis","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Medical School, University of Ioannina, Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Palieraki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Medical School, University of Ioannina, Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PV","family":"Voulgari","sequence":"additional","affiliation":[{"name":"Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Tsifetaki","sequence":"additional","affiliation":[{"name":"Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AA","family":"Drosos","sequence":"additional","affiliation":[{"name":"Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,5,11]]},"reference":[{"key":"bibr1-0961203311398264","doi-asserted-by":"publisher","DOI":"10.1053\/berh.2001.0219"},{"key":"bibr2-0961203311398264","doi-asserted-by":"publisher","DOI":"10.1053\/berh.2001.0223"},{"key":"bibr3-0961203311398264","doi-asserted-by":"publisher","DOI":"10.1177\/0961203306071710"},{"key":"bibr4-0961203311398264","doi-asserted-by":"crossref","unstructured":"McElhone K, Castelino M, Abbott J, et al. 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