Mental health monitoring in adolescents with SLE: associations with lupus low disease activity state and remission
Issued Date
2026-01-01
Resource Type
eISSN
20538790
Scopus ID
2-s2.0-105042180236
Journal Title
Lupus Science and Medicine
Volume
13
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lupus Science and Medicine Vol.13 No.1 (2026)
Suggested Citation
Kongsuk C., Tangkittiwet N., Charuvanij S., Thunsiribuddhichai Y., Pattaragarn A., Piyaphanee N. Mental health monitoring in adolescents with SLE: associations with lupus low disease activity state and remission. Lupus Science and Medicine Vol.13 No.1 (2026). doi:10.1136/lupus-2026-002034 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117496
Title
Mental health monitoring in adolescents with SLE: associations with lupus low disease activity state and remission
Author's Affiliation
Corresponding Author(s)
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Abstract
Objective: Psychological comorbidities are common in adolescents with SLE. Incorporating structured mental-health screening into adolescent SLE care may facilitate improved disease control and holistic well-being. We aimed to evaluate evidence describing changes in mental health including psychological comorbidities and associations with disease states in adolescents with SLE. Methods: A prospective cohort study was conducted in adolescents aged 12–18 years diagnosed with SLE and completed paired assessments at two visits 6–12 months apart. Mental-health measures included the Patient Health Questionnaire-Adolescents (PHQ-A) (depressive symptoms), Generalised Anxiety Disorder (GAD-7) (anxiety), PedsQL Multidimensional Fatigue Scale (PedsQL-MFS) (fatigue), Pittsburgh Sleep Quality Index (PSQI) (sleep quality), Brief Illness Perception Questionnaire (B-IPQ) (illness perception) and visual analogue scale for pain (VAS-P) (pain). Disease states comprised SLE Disease Activity Index 2000 (SLEDAI-2K) (disease activity) and attainment of childhood lupus low disease activity state (cLLDAS) or childhood-onset SLE (cSLE) remission. Group comparisons, paired analyses and correlation analyses were performed. Results: 120 participants were enrolled, of which 117 had complete paired assessments. Most participants were females (90.5%), with a mean age of 15.1±0.2 years. Significant improvement in mental health measures was observed including PHQ-A (3 (1, 6) vs 2 (1, 5), p=0.013), GAD-7 (2 (1, 5) vs 2 (0, 4), p=0.004) and PSQI (4.6±2.8 vs 3.9±2.4, p=0.015) scores, whereas PedsQL-MFS, B-IPQ and VAS-P scores remained unchanged. SLEDAI-2K scores were low (2 (0, 4) vs 2 (0, 3)). The proportions of achieving cLLDAS (64.1% vs 72.6%, p=0.122) and cSLE remission (27.4% vs 35.9%, p=0.021) increased. The relationship between the psychological measures and SLEDAI-2K was not observed; however, active disease (SLEDAI-2K ≥5) was associated with greater fatigue (p=0.015) at the second visit. No associations were identified between the psychological measures and cLLDAS or cSLE remission, consistently in both visits. Conclusions: Mental health monitoring over 6–12 months apart revealed changes in depressive symptoms, anxiety and sleep quality during routine paediatric SLE care. The absence of associations with cLLDAS or remission underscores the importance of integrating mental health outcomes into the treat-to-target strategies.