Prevalence and psychosocial correlates of depression, anxiety and stress among caregivers of children with childhood-onset systemic lupus erythematosus in China: a cross-sectional study

Objectives To investigate the prevalence of depression, anxiety and stress among primary caregivers of children with childhood-onset systemic lupus erythematosus (cSLE) in China and to explore their psychosocial correlates based on the stress process model. Participants 242 primary caregivers were invited, and 211 completed the study (87.2% response rate).

Convenience sampling was used. Eligible participants were unpaid adult caregivers (aged ≥18 years) of children (aged 1 month.

Exclusion criteria included inability to complete questionnaires independently, cognitive impairment due to major physical or mental disorders and current participation in other psychological interventions. Primary and secondary outcome measures Primary outcomes (depression, anxiety and stress) were measured using the Depression Anxiety and Stress Scale-21.

Correlates included threat/challenge appraisal, coping style and perceived social support. Results Among 211 caregivers (mean age 40.55±8.22 years; 77.3% female), 31.8% reported depression, 27.0% anxiety and 24.2% stress.

Higher threat appraisal was consistently associated with depression (regression coefficients (B) =1.012, p<0.001), anxiety (B=0.514, p<0.001) and stress (B=1.091, p<0.001). A higher number of hospitalisations was associated with higher depression (B=0.118, p=0.005) and anxiety (B=0.099, p=0.012).