Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
Department of Psychiatry, University of Toronto, Toronto, Canada.
Lupus. 2021 Jul;30(8):1327-1337. doi: 10.1177/09612033211018504. Epub 2021 Jun 2.
There are no validated screening measures for depressive or anxiety disorders in childhood Systemic Lupus Erythematosus (cSLE). We investigated cross-sectionally (1) the prevalence of depressive and anxiety disorder in cSLE. (2) the validity of the Centre for Epidemiologic Studies Depression Scale for Children (CES-DC) and the Screen for Childhood Anxiety and Related Disorders (SCARED) measures in identifyingthese disorders.
Participants 8-18 years with cSLE/incipient cSLE completed CES-DC, SCARED, and Quality OfMy Life (QOML) measures. Parents completed the SCARED-Parent measure. Diagnosis was by gold-standard psychiatric interview and determined prevalence of psychiatric disorder. Receiver Operating Characteristics Area under the Curve (ROCAUC) evaluated screening measure diagnostic performance.
Ofseventy-two parent-child dyads, 56 interviews were completed. Mean screen scores were: CES-DC = 15 (range 1-49, SD 12), SCARED-C = 22 (range 2-61, SD 14), SCARED-P = 13 (range 0-36, SD 8). Depressive disorder screen positivity (CES-DC ≥ 15) was 35% (vs. prevalence 5%). Anxiety disorder screen positivity (SCARED ≥ 25) was 39% (vs. prevalence 16%). CES-DC ROCAUC = 0.98 and SCARED-C ROCAUC = 0.7 (cut-points 38 and 32 respectively).
Diagnostic thresholds for depressive and anxiety disorderscreening measures are high for both CES-DC and SCARED-C in cSLE. Brief focused interview should follow to determine whether psychiatric evaluation is warranted.
儿童系统性红斑狼疮（cSLE）中尚无经过验证的抑郁或焦虑障碍筛查措施。我们横截面对（1）cSLE 中抑郁和焦虑障碍的患病率，（2）儿童流行病学研究抑郁量表（CES-DC）和儿童焦虑相关障碍筛查量表（SCARED）在识别这些障碍方面的有效性进行了调查。
患有 cSLE/初期 cSLE 的 8-18 岁参与者完成了 CES-DC、SCARED 和生活质量（QOML）量表。父母完成了 SCARED-父母量表。通过金标准精神科访谈确定诊断，并确定精神障碍的患病率。接受者操作特征曲线下面积（ROCAUC）评估筛查量表的诊断性能。
在 72 对父母-孩子对中，完成了 56 次访谈。平均屏幕评分如下：CES-DC=15（范围 1-49，SD 12），SCARED-C=22（范围 2-61，SD 14），SCARED-P=13（范围 0-36，SD 8）。抑郁障碍筛查阳性（CES-DC≥15）为 35%（患病率为 5%）。焦虑障碍筛查阳性（SCARED≥25）为 39%（患病率为 16%）。CES-DC 的 ROCAUC=0.98，SCARED-C 的 ROCAUC=0.7（分别为 38 和 32 的切点）。
CES-DC 和 SCARED-C 在 cSLE 中，用于抑郁和焦虑障碍筛查的诊断阈值都很高。随后应进行简短的重点访谈，以确定是否需要进行精神科评估。
