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Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors
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...
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Published in: | Lupus 2024-07, Vol.33 (8), p.874-885 |
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creator | 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. |
description | 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 (β = 4.2, 95% CI [1.0, 7.3], p = 0.01) and psychiatric condition in a first-degree relative (β = 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. |
doi_str_mv | 10.1177/09612033241254170 |
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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 (β = 4.2, 95% CI [1.0, 7.3], p = 0.01) and psychiatric condition in a first-degree relative (β = 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.</description><identifier>ISSN: 0961-2033</identifier><identifier>ISSN: 1477-0962</identifier><identifier>EISSN: 1477-0962</identifier><identifier>DOI: 10.1177/09612033241254170</identifier><identifier>PMID: 38774953</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Anxiety ; Anxiety disorders ; Children ; Clinical significance ; Demography ; Epidemiology ; Lupus ; Mental depression ; Mental disorders ; Post traumatic stress disorder ; Regression analysis ; Risk factors ; Sociodemographics ; Systemic lupus erythematosus</subject><ispartof>Lupus, 2024-07, Vol.33 (8), p.874-885</ispartof><rights>The Author(s) 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c293t-b729d906453a62a5db45cdb9828e6317af579352546a9df7db49bcd2b36e877a3</cites><orcidid>0000-0002-6872-1758</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38774953$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neufeld, Kate M.</creatorcontrib><creatorcontrib>Moaf, Paris</creatorcontrib><creatorcontrib>Quilter, Michelle</creatorcontrib><creatorcontrib>Danguecan, Ashley N.</creatorcontrib><creatorcontrib>Couture, Julie</creatorcontrib><creatorcontrib>Dominguez, Daniela</creatorcontrib><creatorcontrib>Hendrikx, Olivia</creatorcontrib><creatorcontrib>Ng, Lawrence</creatorcontrib><creatorcontrib>Schachter, Reva</creatorcontrib><creatorcontrib>Korczak, Daphne D.</creatorcontrib><creatorcontrib>Levy, Deborah M.</creatorcontrib><creatorcontrib>Hiraki, Linda</creatorcontrib><creatorcontrib>Knight, Andrea M.</creatorcontrib><title>Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors</title><title>Lupus</title><addtitle>Lupus</addtitle><description>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 (β = 4.2, 95% CI [1.0, 7.3], p = 0.01) and psychiatric condition in a first-degree relative (β = 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.</description><subject>Anxiety</subject><subject>Anxiety disorders</subject><subject>Children</subject><subject>Clinical significance</subject><subject>Demography</subject><subject>Epidemiology</subject><subject>Lupus</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Post traumatic stress disorder</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Sociodemographics</subject><subject>Systemic lupus erythematosus</subject><issn>0961-2033</issn><issn>1477-0962</issn><issn>1477-0962</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp1kc1u1TAQhS0EoreFB2CDLLFh0RT_JHbMDlUtIFViA-vIsSdclyQOHqciD8E711e3gARiYc3ifHM8M4eQF5xdcK71G2YUF0xKUXPR1FyzR2THa62rIojHZHfQqwNwQk4Rbxljkhv1lJzIVuvaNHJHfl7d2XG1OcSZxoF6WBIghjugdvbl_QiQN4rbtOQ4IQ0zdfsw-n2MvoozQi4aZpiCo-O6rEghbXkPk80RV3xLrxN8X2F22zl1cU0I50djxOiCzeBpCviNDtblmPAZeTLYEeH5Qz0jX66vPl9-qG4-vf94-e6mcsLIXPVaGG-YqhtplbCN7-vG-d60ogUlubZDo41syk2UNX7QRTe986KXCsrmVp6R10ffJcUyHuZuCuhgHO0MccVOsqZVUhsuC_rqL_S27DGX6QqlhBatYqpQ_Ei5FBETDN2SwmTT1nHWHbLq_smq9Lx8cF77Cfzvjl_hFODiCKD9Cn--_b_jPWLlnjg</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Neufeld, Kate M.</creator><creator>Moaf, Paris</creator><creator>Quilter, Michelle</creator><creator>Danguecan, Ashley N.</creator><creator>Couture, Julie</creator><creator>Dominguez, Daniela</creator><creator>Hendrikx, Olivia</creator><creator>Ng, Lawrence</creator><creator>Schachter, Reva</creator><creator>Korczak, Daphne D.</creator><creator>Levy, Deborah M.</creator><creator>Hiraki, Linda</creator><creator>Knight, Andrea M.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6872-1758</orcidid></search><sort><creationdate>20240701</creationdate><title>Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-b729d906453a62a5db45cdb9828e6317af579352546a9df7db49bcd2b36e877a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anxiety</topic><topic>Anxiety disorders</topic><topic>Children</topic><topic>Clinical significance</topic><topic>Demography</topic><topic>Epidemiology</topic><topic>Lupus</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Post traumatic stress disorder</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Sociodemographics</topic><topic>Systemic lupus erythematosus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neufeld, Kate M.</creatorcontrib><creatorcontrib>Moaf, Paris</creatorcontrib><creatorcontrib>Quilter, Michelle</creatorcontrib><creatorcontrib>Danguecan, Ashley N.</creatorcontrib><creatorcontrib>Couture, Julie</creatorcontrib><creatorcontrib>Dominguez, Daniela</creatorcontrib><creatorcontrib>Hendrikx, Olivia</creatorcontrib><creatorcontrib>Ng, Lawrence</creatorcontrib><creatorcontrib>Schachter, Reva</creatorcontrib><creatorcontrib>Korczak, Daphne D.</creatorcontrib><creatorcontrib>Levy, Deborah M.</creatorcontrib><creatorcontrib>Hiraki, Linda</creatorcontrib><creatorcontrib>Knight, Andrea M.</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Lupus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neufeld, Kate M.</au><au>Moaf, Paris</au><au>Quilter, Michelle</au><au>Danguecan, Ashley N.</au><au>Couture, Julie</au><au>Dominguez, Daniela</au><au>Hendrikx, Olivia</au><au>Ng, Lawrence</au><au>Schachter, Reva</au><au>Korczak, Daphne D.</au><au>Levy, Deborah M.</au><au>Hiraki, Linda</au><au>Knight, Andrea M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors</atitle><jtitle>Lupus</jtitle><addtitle>Lupus</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>33</volume><issue>8</issue><spage>874</spage><epage>885</epage><pages>874-885</pages><issn>0961-2033</issn><issn>1477-0962</issn><eissn>1477-0962</eissn><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 (β = 4.2, 95% CI [1.0, 7.3], p = 0.01) and psychiatric condition in a first-degree relative (β = 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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>38774953</pmid><doi>10.1177/09612033241254170</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-6872-1758</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Anxiety Anxiety disorders Children Clinical significance Demography Epidemiology Lupus Mental depression Mental disorders Post traumatic stress disorder Regression analysis Risk factors Sociodemographics Systemic lupus erythematosus |
title | Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors |
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