Fatigue and depression predict reduced health-related quality of life in childhood-onset lupus

Abstract

We aimed to identify risk factors for persistently reduced health-related quality of life in childhood-onset lupus and describe a risk profile for persistently reduced health-related quality of life. At a tertiary rheumatology clinic, 50 childhood onset lupus patients were assessed twice, approximately six months apart. Measures of disease activity and patient-reported measures of health-related quality of life, pain, depressive symptoms, anxiety and disability were collected at each visit. At visits 1 and 2, respectively, clinically relevant fatigue was present in 66% and 56% of patients; clinically significant depressive symptoms in 26% and 24%; and clinically significant anxiety in 34% and 28%. Poorer health-related quality of life at follow-up was significantly predicted by higher fatigue and depressive symptoms at the initial visit. Using clinically relevant cut-offs for fatigue and depressive symptoms, patients were assigned to Low ( n = 27) or High Risk ( n = 23) groups. A profile of significantly greater pain, anxiety and coping difficulties was seen in the High Risk group. Routine assessment of fatigue and mood symptoms in youth with childhood-onset lupus could be helpful in identifying those at risk for persistently poor health-related quality of life. Integration of behavioral interventions to address fatigue and mood symptoms into medical care for such patients may be beneficial, but more research in this area is needed.

<p>Effect of Mental Health Problems on the Quality of Life in Children with Lupus Nephritis</p>

“…Lupus nephritis (LN) is a chronic disease that requires a long-term management. 1,2 The disease can cause depression and anxiety disorders that will prolong treatment and increase the disease severity. 3 These conditions impact the disease management and life quality of LN patients.…”

“…3 These conditions impact the disease management and life quality of LN patients. 2,4,5 Treatment of children with LN has increased rapidly by increasing the life span of LN patients, but LN patients have limitations in daily activities, resulting in a new problem, namely, mental health problem. 3,6,7 Children with LN need effective coping to adjust their lives.…”

“…However, the evaluation results can identify those who are at risk of poor health-related life quality so as to improve the treatment of lupus patients based on the needs of each individual. 2 Dr. Soetomo General Academic Hospital, Surabaya, Indonesia is one of the largest hospitals in East Java, Indonesia. The number of pediatric patients with LN in 2018 was 162 patients, and there were new patients reported each month from January to April 2019.…”

Health‐Related Quality of Life Measures in Childhood‐Onset Systemic Lupus Erythematosus

“…Health‐related quality of life (HRQoL) is “a multi‐dimensional concept that includes the physical, psychological, and social functioning associated with an illness or its treatment” (4). SLE is associated with decreased HRQoL in those with the disease compared with healthy populations, and this disparity is increased with higher disease activity, greater damage, fatigue, and depression (5–8). HRQoL is of major concern for children living with cSLE, and an HRQoL assessment is recommended when evaluating response to therapy in patients with cSLE (9–12).…”

Symptom clustering in patients with childhood‐onset systemic lupus erythematosus

“…Both the physical and psychological symptoms perceived by SLE patients may have a negative impact on their quality of life (Pettersson et al., ). Fatigue and depressive symptoms can significantly predict a poorer health‐related quality of life (Donnelly et al., ; Piga et al., ). The ultimate goal of SLE treatment for SLEc patients is to control and maintain the disease activity, decrease patients' symptom distress and improve their quality of life.…”