ArticleRheumatology (Oxford, England)2023
The association of trauma with self-reported flares and disease activity in systemic lupus erythematosus (SLE).
Article in Rheumatology (Oxford, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- Childhood trauma and systemic lupus erythematosus activity in Tunisian patients: exploring the mediating role of post-traumatic stress disorder.Lupus science & medicine · 2026Article
- Anesthesia in systemic lupus erythematosus: a review of key considerations and surgical challenges.Perioperative medicine (London, England) · 2026Review
- Stress exposure prior to diagnosis and clinical characteristics in systemic lupus erythematosus: a cross-sectional study.Rheumatology international · 2026Article
- Adverse childhood experiences are associated with disease and mental health outcomes in childhood-onset SLE.Lupus science & medicine · 2026Article
- Environmental and occupational contributors to autoimmune, inflammatory, and musculoskeletal rheumatic disease: a review of emerging evidence and clinical implications.Current opinion in rheumatology · 2026Review
- The fourth trimester and challenges for the lupus patient.EULAR rheumatology open · 2025Review
- Medical Post-Traumatic Stress Disorder Symptoms in Children and Adolescents with Chronic Inflammatory Arthritis: Prevalence and Associated Factors.Children (Basel, Switzerland) · 2025Article
- Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history.Lupus science & medicine · 2024Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesTrauma has been linked to incident SLE, but its relationship with SLE disease activity is unknown. This analysis examines associations between trauma exposures and patient-reported SLE disease activity and flares.
methodsData were from the California Lupus Epidemiology Study (CLUES). Flares were self-reported as any flare and, of those, flares accompanied by medical care (hospitalization or physician contact). The Systemic Lupus Activity Questionnaire (SLAQ) assessed disease activity. The Brief Trauma Questionnaire (BTQ) assessed all historical trauma exposures. The Adverse Childhood Experiences (ACEs) questionnaire was available for a subset. Multivariable regression analyses (n = 252) examined whether trauma exposure was associated with flares or SLAQ controlling for age, sex, poverty, race/ethnicity, comorbidities, perceived stress, disease duration and self-reported disease damage.
resultsExcluding exposure to serious illness, 63.4% reported ≥1 trauma exposure. Any traumatic event, excluding illness, doubled the odds of a flare [OR 2.27 (95% CI 1.24, 4.17)] and was associated with significantly higher SLAQ scores [β 2.31 (0.86, 3.76)]. Adjusted odds of any flare and flare with medical care were significantly elevated for those with both BTQ and ACE exposures [5.91 (2.21, 15.82) and 4.69 (1.56, 14.07), respectively]. SLAQ scores were also higher for those with both exposures [β 5.22 (3.00, 7.44)].
conclusionIn this cohort, those with a history of trauma reported more flares and greater disease activity. Identifying mechanisms of associations between trauma and disease activity and flares, as well as interventions to mitigate the effects of trauma exposures is critical, given the high rates of trauma exposures.
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