Depression and Psychiatric Care Often Overlooked in Pediatric Systemic Lupus Erythematosus

This Clinical Perspectives manuscript examines depression as a frequently overlooked but clinically consequential comorbidity in pediatric systemic lupus erythematosus (SLE). Depression in youth with SLE contributes to poorer adherence, increased disease activity, and diminished quality of life, yet it is often unrecognized in routine rheumatologic care. Using a representative case illustration and synthesis of current evidence, the paper argues that depression should be treated as an integral component of lupus care rather than a secondary concern. The manuscript outlines practical recommendations for early detection, illness-focused psychotherapy, coordinated pharmacologic management, and family-centered, culturally responsive interventions that can be implemented within pediatric rheumatology and child and adolescent psychiatry settings. The goal is to offer actionable, cost-conscious strategies to advance evidence-informed, equitable mental health care for medically complex youth.