Psychiatric comorbidity boosts healthcare use in youth with newly diagnosed SLE

Young patients with newly diagnosed systemic lupus erythematosus (SLE) are vulnerable to psychiatric comorbidity, which tends to increase healthcare utilization, according to a study.

This retrospective cohort study was carried out using claims from 2000 to 2013 from Clinformatics Data mart (OptumInsight).

The research team categorized patients aged 10‒24 years with an incident diagnosis of SLE (≥3 International Classification of Diseases, 9th revision, codes for SLE 719.0, >30 days apart) as having one of the following: (1) a preceding psychiatric diagnosis in the year before SLE diagnosis, (2) an incident psychiatric diagnosis in the year after SLE diagnosis, or (3) no psychiatric diagnosis.

Ambulatory, emergency, and inpatient visits in the year following SLE diagnosis were compared and stratified by nonpsychiatric and psychiatric visits. The researchers then assessed the impact of childhood- vs adult-onset SLE by testing for an interaction between age and psychiatric exposure on outcome.

A total of 650 youth with an incident diagnosis of SLE were identified. Of these, 122 (19 percent) had a preceding psychiatric diagnosis and 105 (16 percent) an incident psychiatric diagnosis.

Patients with SLE and a preceding or incident psychiatric diagnosis had greater healthcare use across both ambulatory and emergency settings for both psychiatric-related and nonpsychiatric care compared to those without such diagnosis. Notably, age at time of SLE diagnosis had minimal impact on these associations.

“Interventions to address preceding and incident psychiatric comorbidity may decrease healthcare burden for youth with SLE,” the researchers said.