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Effect of Mental Health Problems on the Quality of Life in Children with Lupus Nephritis
Azwin Mengindra Putera1, Irwanto Irwanto1, Margarita Maria Maramis2
1Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Insights
Mental health issues like anxiety and depression significantly impair the quality of life (QoL) in pediatric patients with lupus nephritis (LN). QoL is notably lower during the induction phase compared to the maintenance phase.
Area of Science:
- Pediatric Nephrology
- Child Psychology
- Rheumatology
Background:
- Mental health problems, including anxiety and depression, are prevalent in children with lupus nephritis (LN).
- These psychological challenges can exacerbate disease severity and complicate management, negatively impacting patients' quality of life (QoL).
Purpose of the Study:
- To analyze the association between depression, anxiety, coping mechanisms, and disease activity with the QoL in pediatric patients diagnosed with LN.
- To compare these factors between the induction and maintenance phases of LN treatment.
Main Methods:
- A cohort of 62 pediatric patients with LN was studied, divided into induction (16) and maintenance (46) phases.
- Participants underwent assessments for anxiety, depression, coping strategies, disease activity (Systemic Lupus Erythematosus Disease Activity Index/SLEDAI), and QoL.
- Multiple logistic regression analysis was employed to determine associations, with statistical significance set at p <0.05.
Main Results:
- Significant differences were observed in anxiety, depression, coping, SLEDAI scores, and QoL between the induction and maintenance phases (p <0.001 for most).
- Anxiety and depression levels were significantly higher in the induction phase.
- Lower QoL scores were recorded in the induction phase compared to the maintenance phase.
Conclusions:
- Mental health disorders are strongly linked to reduced QoL in pediatric patients with LN.
- The QoL of children with LN is significantly poorer during the induction phase of treatment than during the maintenance phase.
Introduction:
Mental health problems, such as anxiety, depression, and ineffective family coping, in children with lupus nephritis (LN) can increase the severity and affect the management of the disease, thus affecting the quality of life (QoL) of patients.
Objective:
Analyzing the association between levels of depression, anxiety, coping, disease activity on the QoL of pediatric patients with LN.
Patients And Methods:
There were 62 pediatric LN participants (16 participants in the induction phase and 46 participants in the maintenance phase). Participants were measured for anxiety, depression, coping, disease activity (systemic lupus erythematosus disease activity index/SLEDAI), and QoL. The measurement results were compared between induction and maintenance groups. Analysis of the association between anxiety, depression, coping, and disease activity with the QoL of children with LN used a multiple logistic regression test with p <0.05.
Results:
The measurement results obtained anxiety (induction = 69.06±3.92 and maintenance = 45.24±10.33; p <0.001), depression (induction = 69.88±3.34 and maintenance = 42.20±9.12; p <0.001), coping (induction = 99.88±12.93 and maintenance = 115.67±7.34; p <0.001), SLEDAI (induction = 15.81±12.58 and maintenance = 0.43±1.26; p <0.001), and QoL (induction = 49.92±12.44 and maintenance = 88.15±8.06; p <0.001).. Anxiety level in the induction group (p = 0.043) and maintenance group (p <0.001; p = 0.032; p = 0.008; p = 0.009). Depression level in the induction group (p = 0.031) and maintenance group (p = 0.024; p = 0.042; p = 0.003). SLEDAI score in the maintenance group (p = 0.003; p = 0.003). Coping in induction group (p = 0.016; p = 0.016) and maintenance group (p = 0.005).
Conclusion:
Mental health disorders reduce the QoL of LN children, and the level of QoL in induction phase is lower than maintenance phase.
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