Racial Differences in Anxiety and Depressive Symptoms Identified in Young People with Lupus

Thousands of children and young people in the United States struggle with lupus. The treatment of the condition requires more aggressive drugs than for adult patients and the adverse effects of the drugs impact biological, psychological, and social development.

To study the issue, a team of researchers at the Children’s Hospital of Philadelphia (CHOP) recently examined anxiety and depression in children with lupus and the found that the children, particularly non-Caucasian youths, commonly deal with anxiety and depression. Lupus is known to be more common in populations other than Caucasian.

Results from the study revealed that compared to healthy young people, youth with lupus had more suicidal thoughts but less access to mental health care. Young people with lupus with depressive symptoms were found also to have less primary care doctor visits than young people without depressive symptoms.

“The findings from the study add to existing, but limited knowledge that depression and anxiety are common in children and adolescents with lupus,” said the study’s lead researcher Dr. Andrea Knight, a faculty member at PolicyLab and the Center for Pediatric Clinical Effectiveness, and attending physician in the Center for Childhood Arthritis and Rheumatic Diseases at CHOP, in a recent news release . “The results present new information on racial differences in depression symptoms for youth with lupus, and the high frequency of suicidal thoughts in this group. The results also shed new light on the likely under-recognition and under-treatment of affected lupus youth, as well as differences in healthcare visits between lupus youth affected and unaffected by mental health symptoms. This provides insight for improving mental health intervention for these youth.”

Childhood-onset lupus primarily affects females in their adolescent years which is the highest period of life for onset of depression and anxiety among children in general. Living with a chronic condition is a well-known risk factor for anxiety and depression. The fact that lupus causes brain inflammation associated with anxiety and depression, adds to possible explanations for the study finding.

Appropriate drug regimens for children with lupus remains a matter of debate within the medical community, with drugs such as steroids having possible effects on the brain and body appearance, which can contribute to depression and anxiety. Other factors such as family history of mental health problems and genetics could also be important.

“Families of children with lupus will benefit from increased awareness that depression, anxiety and suicidal thoughts are common in this condition. Hopefully patients and their families will feel more comfortable talking about symptoms of these mental health conditions,” Knight said in the press release. “They should feel empowered to seek help from their rheumatology and primary care doctors, as there are several options for treatment of depression and anxiety. Early mental health care for youth with lupus is important, because persistent depression and anxiety in adults with lupus has been linked to poorer disease control, quality of life and work functioning.”

Findings from the study were limited because researchers examined only one group of young people with lupus. However, the results form a preliminary exploration basis for mental health issues associated with lupus in young people. Researchers indicated a need for larger studies on anxiety and depression in children and adolescents with lupus.