Routine assessment of fatigue and mood symptoms in youth with childhood-onset lupus could be helpful in identifying those at risk for persistently poor health-related quality of life, according to a recent study. At a tertiary rheumatology clinic, 50 childhood onset lupus patients were assessed twice, approximately 6 months apart. Measures of disease activity and patient-reported measures of health-related quality of life, pain, depressive symptoms, anxiety and disability were collected at each visit. Researchers found:

• At visits 1 and 2, respectively, clinically relevant fatigue was present in 66% and 56% of patients; clinically significant depressive symptoms in 26% and 24%; and clinically significant anxiety in 34% and 28%.
• Poorer health-related quality of life at follow-up was significantly predicted by higher fatigue and depressive symptoms at the initial visit.
• Using clinically relevant cut-offs for fatigue and depressive symptoms, patients were assigned to Low (n=27) or High Risk (n=23) groups.
• A profile of significantly greater pain, anxiety, and coping difficulties was seen in the High Risk group.