KIDNEY FUNCTION, AGE, AND EDUCATION AS CONTRIBUTORS TO DEPRESSION AND ANXIETY IN JUVENILE SYSTEMIC LUPUS ERYTHEMATOSUS
- Brian D. Poole, United States of America
Abstract
Background and Aims
Systemic lupus erythematosus in children younger than 18 years of age is known as Juvenile systemic lupus erythematosus (JSLE). Depression and anxiety are not well understood in JSLE. We investigated the clinical and psychological factors associated with depression and anxiety in JSLE.
Methods
Twenty-nine JSLE patients were recruited for the study. They were given a variety of surveys to test their psychological status and perceptions about their health, including the Hospital Anxiety and Depression scale, the Fatigue Severity Scale, and a Medical outcomes questionnaire (the SF-36). Multiple clinical lab test results were obtained from the patients’ medical records. Univariate and Multivariate analyses were used to compare the patient populations with Adult-onset SLE (ASLE) patients and unaffected controls, and find indicators that correlated with depression and anxiety in JSLE patients.
Results
Kidney disease was associated with depression in the JSLE patients. BUN , BUN/creatinine ratio, and leukocyturia were all significantly associated with depressive symptoms. The BUN/creatinine ratio was the most predictive value for both depression and anxiety.The JSLE patients had less depression than the ASLE, although anxiety was similar. Age and education were protective against depression in the JSLE patients. Psychosocial factors that correlated with depressive symptoms in the JSLE patients included fatigue, pain, poor general health, and inability to perform social and physical roles.
Conclusions
Kidney function correlated with symptoms of depression and anxiety. This may mean that symptomatology is an important indicator of whether the patient needs psychiatric care. Age and education were likely protective against depression in the JSLE population.