Addressing Mental Health in Pediatric Rheumatology

Abstract

To review the current evidence for the management of mental disorders for youth with rheumatologic diseases, and elucidate gaps in knowledge requiring further investigation to improve management of mental health conditions for these patients. Depression and anxiety are common in youth with pediatric rheumatologic diseases and are associated with poor adherence, quality of life, and long-term outcomes. They have a complex etiology and require consideration of overall disease management as well as contributing psychosocial factors. Increasing evidence indicates that current screening strategies fail to fully support this patient population and that many patients with mental health problems go untreated. Effective strategies to approach mental health in pediatric rheumatology patients are likely those that incorporate both behavioral and pharmacological therapies, and include families and social support. Preliminary evidence shows that adopting screening practices in pediatric rheumatology clinics will improve detection of mental disorders and is acceptable to patients and families. Broad mental health screening strategies should be considered for youth with rheumatologic diseases. Further research is necessary to better understand which treatments are most effective for depression, anxiety, and other forms of mental disorders observed in pediatric rheumatology.