A new study confirms a clear link between the severity of depression symptoms and the level of disease activity and disability in adolescent patients with juvenile inflammatory arthritis (JIA).
The findings, presented at the European League Against Rheumatism Annual Congress (EULAR 2016), highlight the importance of psychological health assessments for adolescents with JIA and underline the need for psychological support to be integrated into their routine care, according to researchers.
“We already know there is an association between depression and disease severity in rheumatoid arthritis. Children with JIA have also been shown to have depression, and this is associated with disability,” said lead author Dr. John Ioannou from University College London in the UK.
“However, there has been much less work looking at depression in adolescents with JIA. Specifically, the association between depression and disease severity from initial assessment over a 48-month follow-up period has never been explored in this vulnerable age group with JIA.”
Inflammatory arthritis is a chronic debilitating disease of childhood and adolescence. Although the course of the disease varies, with periods of activity followed by remission, previous studies have shown that up to 70 percent of children continue to report disability and limitation of their activities into adulthood, and the proportion is likely to be higher in those with adolescent-onset JIA.
Within this national collaborative study, undertaken by Laura Hanns as her Ph.D. project, it was found that one in seven out of 102 adolescents with JIA had significant symptoms of depression. The adolescents were recruited into the Childhood Arthritis Prospective Study within six months of the onset of their disease. Depressive symptoms were assessed using the Mood and Feelings Questionnaire (MFQ), researchers relate.
Adolescents with more depressive symptoms at their first visit were found to have a significantly higher number of inflamed joints, a higher number of joints with restricted movement, a higher patient rating of disease severity, more pain and more disability, according to the study’s findings.
All of these symptoms rapidly decreased during the first 12 months of treatment and then stabilized.
After the first year, depressive symptoms at the first visit were no longer associated with future inflamed joint count, restricted joint count and patient rating of disease severity, but remained associated with future higher level of ongoing disability and pain, according to the researchers.