ArticleLupus science & medicine2026
Childhood trauma and systemic lupus erythematosus activity in Tunisian patients: exploring the mediating role of post-traumatic stress disorder.
Article in Lupus science & medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease influenced by multiple factors. Growing evidence suggests that adverse childhood experiences (ACEs) and post-traumatic stress disorder (PTSD) may contribute to immune dysregulation and increased disease activity. However, these associations remain poorly explored in North Africa and the Middle East.
objectiveThis study aimed to investigate the mediating role of PTSD in the path from ACEs to SLE activity.
methodsThis cross-sectional study involved adult patients with SLE treated at the Internal Medicine Department of Mahdia University Hospital between September 2024 and February 2025. We used the validated Arabic version of the WHO Adverse Childhood Experiences International Questionnaire, the Arabic PTSD Checklist for DSM-5. Disease activity was assessed using medical record-derived Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and British Isles Lupus Assessment Group scores. Statistical analyses included χ2 tests and Student's t-tests for group comparisons, Pearson correlation analyses and mediation analysis using the Sobel test.
resultsThis study included 106 Tunisian adults with SLE, predominantly women (88.7%), with a mean age of 48.6 ± 12.8 years. All participants reported at least one ACE, with intra-familial adversities being highly prevalent (96.2%). Extra-familial ACEs were reported by 67% of patients, most commonly community violence (43.4%). Probable PTSD was present in 57.5% of participants. Exposure to community violence (43.4%) was significantly associated with higher disease activity (SLEDAI and BILAG), p<0.001). Patients meeting criteria for probable PTSD also exhibited higher disease activity (SLEDAI: p < 0.001; BILAG: p = 0.044). Mediation analysis showed that PTSD partially mediated the association between childhood community violence and SLE activity, accounting for 27.7% of the total effect on SLEDAI and 41.5% on BILAG.
conclusionPTSD appears to play a key mediating role, highlighting the need for trauma-informed and interdisciplinary approaches in SLE management.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.