Abstract
ObjectivesTo determine if depressive symptoms assessed near diagnosis associate with future measures of pain, disability and disease for adolescent patients diagnosed with JIA.MethodsData were analysed from JIA patients aged 11–16 years recruited to the Childhood Arthritis Prospective Study, a UK-based inception cohort of childhood-onset arthritis. Depressive symptoms (using the Mood and Feelings Questionnaire; MFQ), active and limited joint count, disability score (Childhood Health Assessment Questionnaire), pain visual analogue scale and patient’s general evaluation visual analogue scale were collected. Associations between baseline measures (first visit to paediatric rheumatologist) were analysed using multiple linear regression. Linear mixed-effect models for change in the clinical measures of disease over 48 months were estimated including MFQ as an explanatory variable.ResultsData from 102 patients were analysed. At baseline, median (IQR) age was 13.2 years (11.9–14.2 years) and 14.7% scored over the MFQ cut-off for major depressive disorder. At baseline, depressive symptoms significantly associated with all clinical measures of disease (P ⩽ 0.01). High baseline depressive symptoms scores predicted worse pain (P ⩽ 0.005) and disability (P ⩽ 0.001) 12 months later but not active and limited joint counts.ConclusionsAdolescent patients with JIA and depressive symptoms had more active joints, pain and disability at the time of their first specialist appointment. The associations between baseline depression and both pain and disability continued for at least one year, however, this was not the case for active joint count.
Highlights
Adolescence is recognized by the WHO as ‘the period in human growth and development that occurs after childhood and before adulthood, from ages 10 to 19’ [1]
This study explores the hypothesis that for adolescents with JIA, depressive symptoms are associated with clinical measures of disease at the patient’s first visit to a paediatric rheumatologist and that baseline depressive symptoms may predict future clinical outcomes
Depressive symptoms associate with clinical measures of disease at baseline Relationships between depressive symptoms and measures of disease outcomes at baseline were first investigated in a cross-sectional analysis
Summary
Adolescence is recognized by the WHO as ‘the period in human growth and development that occurs after childhood and before adulthood, from ages 10 to 19’ [1]. Adolescence is a time of immense biological, social and vocational change [2] It is a high risk period for the development of mental health problems with approximately half of all psychiatric disorders starting between late adolescence and early adulthood [2]. JIA is defined as arthritis of unknown aetiology that begins before the age of 16 years and persists for a minimum of 6 weeks [3]. It comprises seven distinct categories of heterogeneous conditions as defined by the ILAR [3]. The prevalence of JIA in the UK is approximately 1 in 1000 children [4]
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