Background Anxiety and depression are frequent symptoms among children and adolescents with Systemic Lupus Eritematosus (SLE). Its impact and association with different factors require detailed analysis.
Objectives The aim of this study was to determine the frequency of presentation of anxiety and depression symptoms in children and adolescents with SLE, as well as the association between these symptoms and their quality of life, disease activity index (SLEDAI) and immunosuppressant treatment.
Methods SLE pediatric patients between 9 and 17 years of age were enrolled. They underwent an interview and had four variables evaluated: behavior abnormalities, immunosuppressant therapy, time of diagnosis, and SLEDAI. Data on depression and anxiety symptoms as well as quality of life were collected using the Children Depression Inventory (CDI), the Screen for Child Anxiety Related Disorders (SCARED) and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q).
Results 40 patients were included. Mean age was 14±2 years old. Mean time of SLE diagnosis was 22 months. In 52% of cases (n=21) signs of disease activity were found SLEDAI >5). 57% of patients (n=23) presented with anxiety and 37% (n=15) with depression. Finally, 37% (n=15) declared having suicidal ideation after SLE diagnosis. The mean PQ-LES-Q was 56,7 (SD ±7,32). Correlation analysis results showed a positive association between SCARED and CDI (p=0,009), with a weak correlation (correlation coefficient=0,4). As for SCARED and quality of life (PQ-LESQ), a weak negative correlation was found, which was not statistically significant (p=0,13). Analysis association between CDI and PQ-LES-Q evidenced a strong negative correlation (correlation coefficient= - 0,746) which was statistically significant (p<0,000). Psychiatric manifestations and SLEDAI were evaluated finding no association between disease activity index and the presence of depression or anxiety symptoms (p>0,05). Likewise, analysis of anxiety and medications used for SLE treatment was made. It showed that use of prednisone was associated with a higher prevalence of anxiety symptoms (p=0,004). Nonetheless, when comparing mean corticosteroid dose, it was observed that prednisone dose has no association with the presence or absence of psychiatric manifestations (p>0,05).
Conclusions Anxiety is more likely to be present in pediatric patients with SLE than depression. Anxiety is a vulnerability factor for developing depression symptoms and is related with the use of corticosteroids regardless of the dose. SLE has a major impact on quality of life and this impact becomes greater in the presence of depression symptoms.
Disclosure of Interest None declared