评估儿童期系统性红斑狼疮患者的抑郁和焦虑症状:频率、病程和相关风险因素。

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2024-07-01 Epub Date: 2024-05-22 DOI:10.1177/09612033241254170
Kate M Neufeld, Paris Moaf, Michelle Quilter, Ashley N Danguecan, Julie Couture, Daniela Dominguez, Olivia Hendrikx, Lawrence Ng, Reva Schachter, Daphne D Korczak, Deborah M Levy, Linda Hiraki, Andrea M Knight
{"title":"评估儿童期系统性红斑狼疮患者的抑郁和焦虑症状:频率、病程和相关风险因素。","authors":"Kate M Neufeld, Paris Moaf, Michelle Quilter, Ashley N Danguecan, Julie Couture, Daniela Dominguez, Olivia Hendrikx, Lawrence Ng, Reva Schachter, Daphne D Korczak, Deborah M Levy, Linda Hiraki, Andrea M Knight","doi":"10.1177/09612033241254170","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 <u>≥</u>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 <i>p</i> < 0.2 were included in multivariable adjusted models.</p><p><strong>Results: </strong>At baseline, of 51 participants with a mean disease duration of 4.3 years (SD 2.7), 35% (<i>n</i> = 18) and 35% (<i>n</i> = 18) had clinically significant depressive and anxiety symptoms, respectively. Anxiety disorder was diagnosed by psychiatric interview in 14% (<i>n</i> = 7), depressive disorders in 6% (<i>n</i> = 3), and post-traumatic stress disorder in 4% (<i>n</i> = 2). Adverse childhood events and first-degree relative with psychiatric condition were present in 40% (<i>n</i> = 20) and 37% (<i>n</i> = 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], <i>p</i> = 0.01) and psychiatric condition in a first-degree relative (β = 7.3, 95% CI [2.2, 12.4], <i>p</i> = 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 (<i>n</i> = 34) and SCARED (<i>n</i> = 44), depressive and anxiety symptoms were persistent (18%, <i>n</i> = 6; 16%, <i>n</i> = 7), and newly present (24%, <i>n</i> = 8; 16% <i>n</i> = 7) at follow-up.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141111/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors.\",\"authors\":\"Kate M Neufeld, Paris Moaf, Michelle Quilter, Ashley N Danguecan, Julie Couture, Daniela Dominguez, Olivia Hendrikx, Lawrence Ng, Reva Schachter, Daphne D Korczak, Deborah M Levy, Linda Hiraki, Andrea M Knight\",\"doi\":\"10.1177/09612033241254170\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 <u>≥</u>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 <i>p</i> < 0.2 were included in multivariable adjusted models.</p><p><strong>Results: </strong>At baseline, of 51 participants with a mean disease duration of 4.3 years (SD 2.7), 35% (<i>n</i> = 18) and 35% (<i>n</i> = 18) had clinically significant depressive and anxiety symptoms, respectively. Anxiety disorder was diagnosed by psychiatric interview in 14% (<i>n</i> = 7), depressive disorders in 6% (<i>n</i> = 3), and post-traumatic stress disorder in 4% (<i>n</i> = 2). Adverse childhood events and first-degree relative with psychiatric condition were present in 40% (<i>n</i> = 20) and 37% (<i>n</i> = 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], <i>p</i> = 0.01) and psychiatric condition in a first-degree relative (β = 7.3, 95% CI [2.2, 12.4], <i>p</i> = 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 (<i>n</i> = 34) and SCARED (<i>n</i> = 44), depressive and anxiety symptoms were persistent (18%, <i>n</i> = 6; 16%, <i>n</i> = 7), and newly present (24%, <i>n</i> = 8; 16% <i>n</i> = 7) at follow-up.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":18044,\"journal\":{\"name\":\"Lupus\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141111/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lupus\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/09612033241254170\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lupus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/09612033241254170","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/22 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:抑郁和焦虑症状在儿童期发病的系统性红斑狼疮(cSLE)中很常见,但其病因和病程仍不清楚。我们对患有系统性红斑狼疮的青少年抑郁和焦虑症状的频率以及相关的社会人口和疾病因素进行了纵向调查:方法:8-18 岁的 cSLE 患者完成基线测量(人口学问卷、流行病学研究中心儿童抑郁量表(CES-DC)、儿童焦虑相关障碍筛查(SCARED)和精神科访谈),并在 6 个月后完成随访测量(CES-DC 和 SCARED)。在基线和随访时,计算临床上明显的抑郁症状(CES-DC得分>15)或焦虑症状(SCARED得分≥25)的发生率。对基线精神病学访谈诊断进行了统计。在线性回归模型中检验了社会人口统计学因素(邻里物质匮乏程度、种族聚集程度、童年不良事件史、一级亲属患有精神病)、疾病相关因素(病程、主要器官疾病、疾病活动性、糖皮质激素使用情况、合并症)与基线抑郁和焦虑评分之间的关系。将单变量相关性 p < 0.2 的因素纳入多变量调整模型:基线时,在平均病程为 4.3 年(SD 2.7)的 51 名参与者中,分别有 35% (n = 18)和 35% (n = 18)的人有明显的临床抑郁症状和焦虑症状。通过精神科访谈诊断出焦虑症的占 14%(n = 7),抑郁症的占 6%(n = 3),创伤后应激障碍的占 4%(n = 2)。40%(20 人)和 37%(18 人)的患者存在童年不良事件,其一级亲属患有精神疾病。在多变量回归分析中,基线抑郁症状与邻里物质匮乏程度(β = 4.2,95% CI [1.0,7.3],p = 0.01)和一级亲属的精神状况(β = 7.3,95% CI [2.2,12.4],p = 0.006)呈正相关。基线焦虑评分与患者因素之间没有关联。CES-DC(34 人)和 SCARED(44 人)的中位随访时间为 13.5 个月(IQR 10.5,18),随访时抑郁和焦虑症状持续存在(18%,6 人;16%,7 人),新出现(24%,8 人;16%,7 人):在该样本中,抑郁症状和焦虑症状普遍存在且持续存在。抑郁症状与邻里物质匮乏和家族精神病史相关。这些研究结果支持对慢性系统性红斑狼疮患者进行常规社会心理评估,并提供适当的资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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 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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信