Mental Ill-Health in young people with systemic autoinflammatory disease - a scoping review

Systemic autoinflammatory disorders (SAID), immune dysregulation disorders with onset frequently occurring in youth, are defined by unprovoked inflammation. Research suggest inflammation is associated with the pathogenesis of mental ill-health. Separately, research has identified that mental ill-health is prevalent in people with immune dysregulation disorders compared to healthy controls or those with other chronic diseases, and the psychosocial impacts of these diseases on quality of life can be debilitating. This review aimed to broadly identify the extent and nature of research involving young people with SAIDs and mental ill-health. A scoping review was conducted across 6 databases of peer-reviewed articles referring to SAIDs and mental ill-health in young people. Of 727 studies, 41 met the inclusion criteria. Thirty-seven were observational studies, including 18 case studies or series. Four studies were treatment trials. Fourteen observational studies investigated the prevalence of mental ill-health in a SAID population with large sample sizes. Most studies were conducted in Türkiye, involving Behçet's syndrome or familial Mediterranean fever and anxiety, depression, and psychosis were strongly represented. Findings suggest an association between mental ill-health and SAID activity in young people. Anxiety and depression were associated with some specific SAIDs duration, symptom severity, SAID flare recency and frequency, and SAID treatment effects. Co-occurrence and resolution of SAID flares and mental ill-health with treatment were frequent themes in case studies of some SAIDs. Further research is required on the prevalence and risk of developing mental ill-health among young people with SAIDs, along with associations between mental ill-health, other SAIDs and disease activity, other participant variables, and appropriate management of mental ill-health in this population.