792 - Prevalence of Anxiety and Depression in Childhood-onset SLE Cohort in the Southeastern United States.

Publication Number: 792.6317

Shalini Bajaj, Nemours Children's Hospital, Orlando, FL, United States; Roshan P. George, Emory University School of Medicine, Atlanta, GA, United States; Erin harlow-parker, Children’s Healthcare of Atlanta, Atlanta, GA, United States; Kelly Rouster-Stevens, Emory University/Children's Healthcare of Atlanta, Atlanta, GA, United States; Ekemini A. Ogbu, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Chronic diseases such as childhood-onset Systemic lupus erythematous (cSLE) may be associated with depression and anxiety leading to poorer outcomes. Limited data is available on prevalence of anxiety and depression in cSLE, especially in diverse racial and ethnic populations.

Objective: To investigate the prevalence of anxiety and depression in cSLE, examine racial and ethnic differences and identify other risk factors.

Design/Methods: This cross-sectional study was conducted at a large single academic medical center in Southeastern US between June 2023 to December 2023 including patients aged 8 to 20 years who met the 1997 ACR classification criteria for SLE prior to age 16 years. Patient reported outcomes measurement information system (PROMIS) short form questionnaires for anxiety and depression were completed once by all patients immediately after a routine rheumatology visit. For children less than 18 years, parents/guardians also completed anxiety and depression proxy questionnaires. We assessed the prevalence and severity of anxiety and depression by age, race, ethnicity, sex and disease activity using the systemic lupus erythematosus disease activity index-2K (SLEDAI-2K). We assessed the degree of agreement of anxiety and depression severity within parent/guardian-child dyads.

Results: Our study cohort of 78 children was predominantly Black (62%) and female (92%) with median age 17 years (Range 8-20 years)and Mean SLEDAI-2k 2.9 (SD ±3.8). Prevalence of anxiety was 59%; 37% of patients had moderate to severe anxiety. Prevalence of depression was 46%; 31% of patients had moderate to severe depression. Both moderate to severe anxiety and depression were present in 24% (n = 19) of patients. Prevalence of anxiety was higher in females compared to males (Table 1).
We found no other statistically significant racial, ethnic, or other demographic differences or clinical risk factors associated with anxiety and depression. However, there were trends to suggest that anxiety was more prevalent among older participants (>18 to 20 years) and those with active SLE (SLEDAI-2k >4). Depression was more prevalent among those with longer disease duration (>1 year) and active SLE. The degree of agreement for anxiety (kappa=0.32) and depression (kappa = 0.23) between parents/guardians and their child was fair.

Conclusion(s): There is a high prevalence of anxiety and depression in cSLE overall, and in Black patients with cSLE. Parental perspective could be helpful in screening for anxiety and depression in children. A better understanding of modifiable risk factors of anxiety and depression in cSLE is still needed.

Table 1: Comparison of Patient Demographics, Clinical Characteristics and Outcomes by Anxiety and Depression Status
Final abstract table 2.pdf