Lupus patients who had difficult childhoods have higher disease activity, worse depression and poorer overall health than those with better childhoods, a new study finds.
Bad childhood experiences included abuse, neglect and household challenges.
The study included 269 lupus patients in California. Of those, about 63% reported at least one type of bad childhood experience, and about 19% reported at least four. Rates in the lupus patients were similar to those in the general population.
Bad childhood experiences were more common among lupus patients who were older, female, Hispanic or black, did not have a college degree, and had kidney inflammation from lupus (lupus nephritis).
The greater the number of bad childhood experiences, the worse a patient's self-reported lupus activity, depression and overall health.
For example, those with more than four bad childhood experiences reported nearly double the disease activity scores of those with no adverse childhood experiences.
These findings were not significantly associated with doctor-assessed lupus activity, damage or severity, according to the University of California, San Francisco study.
"Our results support the notion that stress in the form of [negative childhood experiences] may be a factor in poor health in systemic lupus, both in disease development and in more severe outcomes," said lead author Dr. Kimberly DeQuattro, a clinical fellow in rheumatology.
She called for more effort to prevent abuse and neglect in childhood, "as well as clinical and mental health interventions that foster resilience in adulthood," DeQuattro said in a university news release.
Lupus is an autoimmune disease in which the immune system attacks the body's tissues, causing widespread inflammation and damage in affected organs.
Genetics and the environment play a role in lupus, and stress is a potential trigger of disease onset and flares, and can lead to chronic disability.
"This work in lupus patients supports more broadly the body of studies on adversity and trauma in childhood" that have found a link between negative experiences and health, DeQuattro said, although the study only found an association between the two.
"Our next steps are to look at other types of stress and trauma, how the body responds, and how they relate to lupus outcomes," she noted.
The study was published online May 9 in the journal Arthritis Care & Research.
The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on lupus.