title: Depressive symptoms are prevalent in childhood-onset systemic lupus erythematosus (cSLE).
abstract: BACKGROUND
  Depressive symptoms are common in adolescence and young adulthood; however, their prevalence in childhood-onset systemic lupus erythematosus (cSLE) is unknown.
  
  
  OBJECTIVE
  The objective of this study was to examine the prevalence of depressive symptoms and their association with disease characteristics in children, adolescents, and young adults with cSLE.
  
  
  METHODS
  A cross-sectional sample of patients with cSLE between 10 to 24 years old completed standardized depression inventories. Demographics and disease characteristics were collected.
  
  
  RESULTS
  Total depression inventory scores reported were below standard cut-off values for depression. However, 26% (10/38) of children and adolescents, and 44% (seven of 16) of young adults had scores at or above established cut-offs for elevated depression symptoms. Physical symptoms of depression were endorsed most frequently. There were no differences in depressive symptoms by disease characteristics including disease duration, health-related quality of life inventory scores, antiphospholipid antibody status, and a history of renal involvement or neuropsychiatric SLE (NPSLE). However, two patients had a history of depression as an NPSLE manifestation of their SLE. In the children and adolescents, prednisone dose was associated with negative self-esteem (r = 0.37, p = 0.04) and somatic depressive symptoms (r = 0.39, p = 0.02), but we did not observe a significant association in the young adults.
  
  
  CONCLUSIONS
  Depressive symptoms in cSLE are frequent, although similar to the high prevalence rates in the general population. Physical symptoms are most frequently endorsed. Further study will determine if serial evaluations are recommended for early detection in this at-risk population.
authors.affiliation: York University, Toronto, Canada.
authors.forename: S Ahola
authors.initials: SA
authors.lastname: Kohut
authors.forename: T S
authors.initials: TS
authors.lastname: Williams
authors.forename: J
authors.initials: J
authors.lastname: Jayanthikumar
authors.forename: C
authors.initials: C
authors.lastname: Landolt-Marticorena
authors.forename: A
authors.initials: A
authors.lastname: Lefebvre
authors.forename: E
authors.initials: E
authors.lastname: Silverman
authors.forename: D M
authors.initials: DM
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D020945:Lupus Vasculitis, Central Nervous System / Q000523:psychology*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D055815:Young Adult
keywords: Depression; NPSLE; adolescent; children; neuropsychiatric lupus; pediatric; young adult