{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:56:44Z","timestamp":1781697404414,"version":"3.54.5"},"reference-count":41,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"unspecified","delay-in-days":167,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University","award":["R016631001"],"award-info":[{"award-number":["R016631001"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted in adolescents aged 12\u201318 years diagnosed with SLE and completed paired assessments at two visits 6\u201312 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>120 participants were enrolled, of which 117 had complete paired assessments. Most participants were females (90.5%), with a mean age of 15.1\u00b10.2 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\u00b12.8\u2009vs 3.9\u00b12.4, 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 \u22655) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mental health monitoring over 6\u201312 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2026-002034","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:30:30Z","timestamp":1781695830000},"page":"e002034","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mental health monitoring in adolescents with SLE: associations with lupus low disease activity state and remission"],"prefix":"10.1136","volume":"13","author":[{"given":"Chayanit","family":"Kongsuk","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navaporn","family":"Tangkittiwet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirirat","family":"Charuvanij","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanarin","family":"Thunsiribuddhichai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirut","family":"Pattaragarn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1544-2245","authenticated-orcid":false,"given":"Nuntawan","family":"Piyaphanee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"2026061704300671000_13.1.e002034.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2010.121"},{"key":"2026061704300671000_13.1.e002034.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210960"},{"key":"2026061704300671000_13.1.e002034.3","first-page":"878","article-title":"Depressive and anxiety symptom prevalence in childhood-onset systemic lupus erythematosus: A systematic review","volume":"28","author":"Quilter","year":"2019","journal-title":"Lupus (Los Angel)"},{"key":"2026061704300671000_13.1.e002034.4","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/acr.22650","article-title":"Pain, Fatigue, and Psychological Impact on Health-Related Quality of Life in Childhood-Onset Lupus","volume":"68","author":"Jones","year":"2016","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026061704300671000_13.1.e002034.5","first-page":"1630","article-title":"Depression, anxiety, and sleep quality in childhood onset systemic lupus erythematosus and relationship with brain-derived neurotrophic factor","volume":"31","author":"Baba","year":"2022","journal-title":"Lupus (Los Angel)"},{"key":"2026061704300671000_13.1.e002034.6","first-page":"395","article-title":"Illness perception and psychological distress in adolescents with systemic lupus erythematosus","volume":"34","author":"Tangkittiwet","year":"2025","journal-title":"Lupus (Los Angel)"},{"key":"2026061704300671000_13.1.e002034.7","first-page":"124","article-title":"Fatigue and depression predict reduced health-related quality of life in childhood-onset lupus","volume":"27","author":"Donnelly","year":"2018","journal-title":"Lupus (Los Angel)"},{"key":"2026061704300671000_13.1.e002034.8","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.2147\/NDT.S250373","article-title":"Effect of Mental Health Problems on the Quality of Life in Children with Lupus Nephritis","volume":"16","author":"Putera","year":"2020","journal-title":"Neuropsychiatr Dis Treat"},{"key":"2026061704300671000_13.1.e002034.9","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2025-073172","article-title":"AAP Section on Developmental and Behavioral Pediatrics; AAP Council on Early Childhood; AAP Committee on Psychosocial Aspects of Child and Family Health; SOCIETY FOR DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS. 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