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26-06-2019 | Rheumatology | News | Article

Anxiety, depressive symptoms linked to pain and disability in JIA

medwireNews: Anxiety and depressive symptoms are associated with pain and disability but not active joint count or biomarkers of inflammation in adolescents with juvenile idiopathic arthritis (JIA), researchers report.

In spite of this, Yiannis Ioannou (University College London, UK) and co-investigators also found that the levels of anxiety and depressive symptoms in these patients are similar to those observed among their healthy peers.

They say that this could reflect “the generally good control of disease activity,” among the 136 patients (median age 17 years) with JIA that they studied.

“Had we recruited only those patients experiencing a flare of disease, then we may have seen differences in the anxiety scores and depressive symptoms of adolescent JIA patients compared to healthy controls,” they add.

Ioannou and co-authors report in Arthritis Care & Research that there was no significant difference between the patients with JIA and 88 healthy controls (median age 16 years) in the median scores for overall anxiety (70.0 vs 77.0), state anxiety (33.0 vs 35.5), and trait anxiety (37.9 vs 41.0), as measured by the State-Trait Anxiety Inventory.

There was also no difference between the two groups in the median self-reported depressive symptoms score (3 vs 4), assessed using the Mood and Feelings Questionnaire.

Among the patients with JIA, anxiety significantly and positively correlated with pain, disability (Child Health Assessment Questionnaire), and physician global assessment visual analogue scale, but not with active joint count, after accounting for potentially confounding variables.

There was also no association between anxiety and levels of serum interleukin (IL)-6, C-reactive protein, and cortisol, erythrocyte sedimentation rate, and the stimulated IL-6 response of peripheral blood mononuclear cells.

And the researchers observed similar associations between depressive symptoms and each of the outcome measures they tested.

“Since our results show that anxiety and depression associate with pain and disability, access to a dedicated paediatric rheumatology psychologist may benefit patients,” Ioannou et al remark.

They add: “A paediatric rheumatology psychologist could work with physiotherapists and occupational health services to address pain, disability and mental wellbeing in one integrated care package for adolescents with JIA.”

But the team cautions that the cross-sectional nature of the study means “the directionality behind associations found remains unknown.”

By Laura Cowen

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

Arthritis Care Res 2019; doi:10.1002/acr.24006

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