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Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors.
Neufeld, Kate M; Moaf, Paris; Quilter, Michelle; Danguecan, Ashley N; Couture, Julie; Dominguez, Daniela; Hendrikx, Olivia; Ng, Lawrence; Schachter, Reva; Korczak, Daphne D; Levy, Deborah M; Hiraki, Linda; Knight, Andrea M.
Afiliación
  • Neufeld KM; Division of Pediatric Rheumatology, Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
  • Moaf P; Department of Neurosciences and Mental Health, Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.
  • Quilter M; Department of Psychiatry, Whyteman's Brae Hospital, NHS Fife, Kirkaldy, Scotland.
  • Danguecan AN; Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
  • Couture J; Division of Pediatric Rheumatology, Department of Pediatrics, Centre mère-enfant Soleil du CHU de Québec, Laval University, Quebec City, QC, Canada.
  • Dominguez D; Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.
  • Hendrikx O; Department of Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.
  • Ng L; Bachelor of Health Sciences, Queen's University, Kingston, ON, Canada.
  • Schachter R; Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.
  • Korczak DD; Division of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.
  • Levy DM; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.
  • Hiraki L; Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.
  • Knight AM; Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Lupus ; 33(8): 874-885, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38774953
ABSTRACT

BACKGROUND:

Depressive and anxiety symptoms are common in childhood-onset systemic lupus erythematosus (cSLE), yet their etiology and course remain unclear. We investigated the frequency of depressive and anxiety symptoms longitudinally in youth with cSLE, and associated socio-demographic and disease factors.

METHODS:

Participants 8-18 years with cSLE completed baseline measures [demographic questionnaire, Center for Epidemiologic Studies Depression Scale for Children (CES-DC), Screen for Childhood Anxiety Related Disorders (SCARED), and psychiatric interview] and follow-up measures (CES-DC and SCARED) > 6 months later. Prevalence of clinically significant depressive (score >15 on CES-DC) or anxiety symptoms (score ≥25 on SCARED) was calculated at baseline and follow-up. Baseline psychiatric interview diagnoses were tabulated. Relationships between socio-demographics (neighborhood-level material deprivation, ethnic concentration, adverse childhood event history, psychiatric condition in a first-degree relative), disease-related factors (disease duration, major organ disease, disease activity, glucocorticoid use, comorbid medical condition) and baseline depressive and anxiety scores, were examined in linear regression models. Factors with univariate associations with p < 0.2 were included in multivariable adjusted models.

RESULTS:

At baseline, of 51 participants with a mean disease duration of 4.3 years (SD 2.7), 35% (n = 18) and 35% (n = 18) had clinically significant depressive and anxiety symptoms, respectively. Anxiety disorder was diagnosed by psychiatric interview in 14% (n = 7), depressive disorders in 6% (n = 3), and post-traumatic stress disorder in 4% (n = 2). Adverse childhood events and first-degree relative with psychiatric condition were present in 40% (n = 20) and 37% (n = 18), respectively. In multivariable regression analysis, baseline depressive symptoms were positively correlated with neighbourhood-level material deprivation (ß = 4.2, 95% CI [1.0, 7.3], p = 0.01) and psychiatric condition in a first-degree relative (ß = 7.3, 95% CI [2.2, 12.4], p = 0.006). No associations were found between baseline anxiety scores and patient factors. At a median follow-up of 13.5 months (IQR 10.5, 18) for CES-DC (n = 34) and SCARED (n = 44), depressive and anxiety symptoms were persistent (18%, n = 6; 16%, n = 7), and newly present (24%, n = 8; 16% n = 7) at follow-up.

CONCLUSION:

In this sample, depressive and anxiety symptoms were prevalent and persistent. Depressive symptoms correlated with neighborhood-level material deprivation, and family psychiatric history. These findings support routine psychosocial assessment in cSLE, and provision of appropriate resources.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ansiedad / Depresión / Lupus Eritematoso Sistémico Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Lupus Asunto de la revista: REUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ansiedad / Depresión / Lupus Eritematoso Sistémico Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Lupus Asunto de la revista: REUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido