E21 Pain catastrophism in Juvenile Idiopathic Arthritis

Abstract

Abstract Introduction Catastrophism, or dramatization, is a cognitive and affective response that is based on an inadequate perception of pain. It is characterized by a negative mindset and magnification of pain through the interaction of physiological and psychological processes. Thanks to the development of a pediatric version of the Pain Catastrophizing Scale (PCS), the interest in pain catastrophizing in the pediatric area is progressively increasing. Persistent pain is the most common and bothersome symptom of Juvenile Idiopathic Arthritis (JIA). Our goal was to evaluate pain catastrophism in JIA patients as well as the factors that are associated. Patients and Methods We conducted a cross-sectional monocentric study on 12–18-year-old patients with JIA. Only those who agreed to participate were included. We collected socio-demographic and clinical data including Juvenile Arthritis Disease Activity Score (JADAS) and Patient Global Assessment (PGA). Catastrophism was evaluated by the French version of the Pain Catastrophizing Scale (PCS) adapted for adolescents (PCS-Ado). A PCS score of 30 or more represents a high level of catastrophism. Regarding quantitative variables, the normality of the variables was assessed by the Kolmogorov-Smirnov test. We calculated the median and variance of data with no Gaussian distribution and the mean with Standard deviation in quantitative variables with the normal curve. For the comparison of 2 independent series, we used the Mann–Whitney test for independent series. The Spearman test was used to calculate the correlation coefficient (r) between two quantitative variables. The significance level in all statistical tests was set at 0.05. Results Our study included a total of 20 JIA patients with a male predominance of 65%. The mean age was 14.30 ± 1.87 years and the mean disease duration was 3.39 ± 2.49 years. The Enthesitis Related Arthritis (ERA) form was noted in 50% of JIA patients. The average PGA was 3.86 ± 2.88. Mean JADAS was 6.45 ± 6.05. The PCS-Ado score was 32/52 on average. In 60% of cases, there was a high level of catastrophism (PCS-Ado ≥30). No statistically significant differences were seen in PCS-Ado based on gender, age, disease duration, or JADAS. However, statistical analysis showed that the ERA form had significantly higher PCS-Ado than the non-ERA form (mean PCS-Ado: 36.87 vs 26.75; P = 0.026). We also found a positive correlation between PCS-Ado and PGA (P = 0.026; r = 0.591). Conclusion In our study, more than half of patients with JIA had high PCS scores with a significant relationship to ERA form and PGA. This leads us to systematically detect catastrophist thinking in this population to avoid amplifying pain and installing emotional distress and pain-related disability.