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      Neuropsychiatric Disease and Treatment (submit here)

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      Effect of Mental Health Problems on the Quality of Life in Children with Lupus Nephritis

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          Abstract

          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.

          Most cited references55

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          Epidemiology and treatment of depression in patients with chronic medical illness

          There is a bidirectional relationship between depression and chronic medical disorders. The adverse health risk behaviors and psychobiological changes associated with depression increase the risk for chronic medical disorders, and biological changes and complications associated with chronic medical disorders may precipitate depressive episodes. Comorbid depression is associated with increased medical symptom burden, functional impairment, medical costs, poor adherence to self-care regimens, and increased risk of morbidity and mortality in patients with chronic medical disorders. Depression may worsen the course of medical disorders because of its effect on proinflammatory factors, hypothalamic-pituitary axis, autonomic nervous system, and metabolic factors, in addition to being associated with a higher risk of obesity, sedentary lifestyle, smoking, and poor adherence to medical regimens. Both evidence-based psychotherapies and antidepressant medication are efficacious treatments for depression. Collaborative depression care has been shown to be an effective way to deliver these treatments to large primary care populations with depression and chronic medical illness.
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            Gratitude in intermediate affective terrain: links of grateful moods to individual differences and daily emotional experience.

            Two studies were conducted to explore gratitude in daily mood and the relationships among various affective manifestations of gratitude. In Study 1, spiritual transcendence and a variety of positive affective traits were related to higher mean levels of gratitude across 21 days. Study 2 replicated these findings and revealed that on days when people had more grateful moods than was typical for them, they also reported more frequent daily episodes of grateful emotions, more intense gratitude per episode, and more people to whom they were grateful than was typical for them. In addition, gratitude as an affective trait appeared to render participants' grateful moods somewhat resistant to the effects of discrete emotional episodes of gratitude.
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              The Revised Child Anxiety and Depression Scale-Short Version: scale reduction via exploratory bifactor modeling of the broad anxiety factor.

              Using a school-based (N = 1,060) and clinic-referred (N = 303) youth sample, the authors developed a 25-item shortened version of the Revised Child Anxiety and Depression Scale (RCADS) using Schmid-Leiman exploratory bifactor analysis to reduce client burden and administration time and thus improve the transportability characteristics of this youth anxiety and depression measure. Results revealed that all anxiety items primarily reflected a single "broad anxiety" dimension, which informed the development of a reduced 15-item Anxiety Total scale. Although specific DSM-oriented anxiety subscales were not included in this version, the items comprising the Anxiety Total scale were evenly pulled from the 5 anxiety-related content domains from the original RCADS. The resultant 15-item Anxiety Total scale evidenced significant correspondence with anxiety diagnostic groups based on structured clinical interviews. The scores from the 10-item Depression Total scale (retained from the original version) were also associated with acceptable reliability in the clinic-referred and school-based samples (α = .80 and .79, respectively); this is in contrast to the alternate 5-item shortened RCADS Depression Total scale previously developed by Muris, Meesters, and Schouten (2002), which evidenced depression scores of unacceptable reliability (α = .63). The shortened RCADS developed in the present study thus balances efficiency, breadth, and scale score reliability in a way that is potentially useful for repeated measurement in clinical settings as well as wide-scale screenings that assess anxiety and depressive problems. These future applications are discussed, as are recommendations for continued use of exploratory bifactor modeling in scale development.
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                Author and article information

                Journal
                Neuropsychiatr Dis Treat
                Neuropsychiatr Dis Treat
                NDT
                neurodist
                Neuropsychiatric Disease and Treatment
                Dove
                1176-6328
                1178-2021
                26 June 2020
                2020
                : 16
                : 1583-1593
                Affiliations
                [1 ]Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital , Surabaya, Indonesia
                [2 ]Department of Psychiatry, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital , Surabaya, Indonesia
                Author notes
                Correspondence: Azwin Mengindra Putera Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital , Jl. Mayjen Prof. Dr. Moestopo No. 6–8, Airlangga, Gubeng, Surabaya, East Java60286, IndonesiaTel +6231-5501218 Email azwinmengindraputera@gmail.com
                Author information
                http://orcid.org/0000-0002-8698-720X
                http://orcid.org/0000-0002-7573-8793
                http://orcid.org/0000-0001-8898-5470
                http://orcid.org/0000-0002-1708-5384
                Article
                250373
                10.2147/NDT.S250373
                7326200
                32617005
                a2d4a820-5025-4012-b3aa-3085fd31d160
                © 2020 Putera et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 18 February 2020
                : 01 June 2020
                Page count
                Figures: 1, Tables: 4, References: 57, Pages: 11
                Categories
                Original Research

                Neurology
                anxiety,depression,disease activity,coping,quality of life,lupus nephritis
                Neurology
                anxiety, depression, disease activity, coping, quality of life, lupus nephritis

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