Anxiety, depressive symptoms in JIA tied to pain, stress

Moderate to severe symptoms of anxiety and depression have been reported in about one-fourth of children with juvenile idiopathic arthritis (JIA), according to a study. Such symptoms are associated with pain and stress, but not with other disease manifestations.

A team of investigators conducted a cross-sectional study of children with JIA and a parent proxy who completed PROMIS measures on depression, anxiety, stress, and pain. They used the Childhood Health Assessment Questionnaire (CHAQ) measured mobility and the clinical Juvenile Arthritis Disease Activity Score in 10 joints (cJADAS10) to measure disease activity.

Eighty-four patients (median age 14 years, disease duration 4.73 years, CHAQ score 0, total active joint count 0, cJADAS10 2) completed the study. Fifty-seven patients (70 percent) had inactive or low disease activity based on cJADAS10. Compared to the reference population, children with JIA had lower mean PROMIS t-scores for depressive and anxiety symptoms (p<0.0001).

Nineteen patients (23 percent) had moderate to severe symptoms of anxiety and/or depression. Age (r, 0.36; p=0.0008) and CHAQ (r, 0.32; p=0.0029) score (mobility) were associated with depressive symptoms, but not anxiety. Depressive and anxiety symptoms correlated with pain (r, 0.64 and 0.47, respectively; p<0.0001) and stress (r, 0.79 and 0.75, respectively; p<0.0001), but not with sex, JIA subtype, disease duration, or disease activity.

“Understanding how mental health symptoms and JIA affect each other is necessary in order to improve patient outcomes and provide well-rounded care,” the investigators said.