Evaluation of self-report screening measures in the detection of depressive and anxiety disorders among children and adolescents with systemic lupus erythematosus

Abstract

Background There are no validated screening measures for depressive or anxiety disorders in childhood Systemic Lupus Erythematosus (cSLE). We investigated cross-sectionally (1) the prevalence of depressive and anxiety disorder in cSLE. (2) the validity of the Centre for Epidemiologic Studies Depression Scale for Children (CES-DC) and the Screen for Childhood Anxiety and Related Disorders (SCARED) measures in identifyingthese disorders. Methods Participants 8-18 years with cSLE/incipient cSLE completed CES-DC, SCARED, and Quality OfMy Life (QOML) measures. Parents completed the SCARED-Parent measure. Diagnosis was by gold-standard psychiatric interview and determined prevalence of psychiatric disorder. Receiver Operating Characteristics Area under the Curve (ROCAUC) evaluated screening measure diagnostic performance. Results Ofseventy-two parent-child dyads, 56 interviews were completed. Mean screen scores were: CES-DC = 15 (range 1-49, SD 12), SCARED-C = 22 (range 2-61, SD 14), SCARED-P = 13 (range 0-36, SD 8). Depressive disorder screen positivity (CES-DC ≥ 15) was 35% (vs. prevalence 5%). Anxiety disorder screen positivity (SCARED ≥ 25) was 39% (vs. prevalence 16%). CES-DC ROCAUC = 0.98 and SCARED-C ROCAUC = 0.7 (cut-points 38 and 32 respectively). Conclusions Diagnostic thresholds for depressive and anxiety disorderscreening measures are high for both CES-DC and SCARED-C in cSLE. Brief focused interview should follow to determine whether psychiatric evaluation is warranted.

Evaluation of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus: Frequency, course, and associated risk factors

“…Our previous work showed a high prevalence of selfreported depressive and anxiety symptoms at 35% and 39%, respectively, in cross-sectional study of children with cSLE 20 which were significantly associated with worse quality of life. Despite high rates of depression and anxiety disorders in cSLE and significant impact on daily life, depression and anxiety assessment are not routinely performed by clinicians using standardized instruments.…”

Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

“…SLE can be particularly severe in childhood. Neuropsychiatric tendencies in this disease, as well as medications taken, may lead to the occurrence of anxiety disorders, often related to the chronic disease process in pediatric patients [69,70]. Children and adolescents are particularly susceptible to these problems due to chronic disease and often lack of acceptance of this condition by peers.…”

“…Children and adolescents are particularly susceptible to these problems due to chronic disease and often lack of acceptance of this condition by peers. These burdens may lead to chronic anxiety [70][71][72]. Taken medications, including glucocorticosteroids, have many side effects.…”

“…Taken medications, including glucocorticosteroids, have many side effects. They may lead to low mood, which increases the risk of depression and anxiety disorders, which may also present as NPSLE [70,73]. Another cause of anxiety disorders in this group of patients is chronic pain, which reduces the quality of life [70,74].…”

Early Detection of Depression in Children and Adolescents With Chronic Disease During the Covid-19 Pandemic

“…Penyakit kronis yang membatasi aktivitas fisik misalnya pada Lupus eritematosus sistemik (LES) memiliki efek yang tidak diinginkan pada kesehatan mental sehingga menyebabkan masalah mental dan emosional pada pasien dan keluarga (Reid et al, 2021). Beberapa penelitian mendapatkan adanya kecemasan (34-37%) dan gejala depresi (6,7-59%) pada anak LES (Quilter et al, 2021). Penelitian lain oleh Jones mendapatkan masalah psikososial yang paling umum pada remaja dengan penyakit kronis antara lain kelelahan (65%), nyeri (40%), kecemasan (37%), dan gejala depresi (30%) (Jones et al, 2016).…”