Associação entre experiências adversas na infância com as manifestações clínicas e a presença de danos permanentes causados pelo lúpus eritematoso sistêmico em mulheres adultas

Abstract

Adverse childhood experiences (ACE) increase the prevalence of neuropsychological disorders, changes in child development and the emergence of autoimmune diseases with complications in adult life. Objective: To associate ACE with the presence of permanent damage and the clinical manifestations of Systemic Lupus Erythematosus (SLE) in adult women. Methods: This is a cross-sectional observational analytical study in a sample of 97 women diagnosed with SLE, whose data were collected through interviews and review of medical records. ACE were identified using the Childhood Trauma Questionnaire (CTQ) which addresses the types of abuse (physical, emotional and sexual) and neglect (physical and emotional) in childhood, with 5 questions from each sublevel, whose score 5 means absence of ACE and score ≥ 6 presence of ACE. ACE were associated, considering p-values < 0.05 as statistically significant, with sociodemographic data, clinical manifestations and the presence of damage (permanent damage index > 6 months) in SLE. Results: Among the 97 women interviewed in this study, it was observed that all participants scored in at least one subtype of ACE. Significant associations were found for sublevels and clinical manifestations, such as physical abuse with systemic arterial hypertension (p=0.034) and nephritis (p=0.006); for emotional abuse with photosensitivity (p=0.006); for sexual abuse with Sjogren's syndrome (p=0.004), oral ulcer (p=0.030) and involvement of the pulmonary system (p=0.006); and for physical neglect with diabetes mellitus (p=0.022) and human immunodeficiency virus (p=0.041). Patients with a mean ≥ 6 for ACE showed a significant association with the inability to work, however, no significant associations were found with the presence of permanent damage and physical neglect. Conclusion: The present study shows that some clinical manifestations of SLE are significantly associated with some subtypes of ACE, which shows the importance of preventing childhood trauma in order to improve health in adulthood.