Juvenile idiopathic arthritis (JIA) is a chronic painful disorder
conceivably with adverse psychological sequelae that might influence
the outcome of the disease and its treatment. This study was designed
to detect the presence of psychiatric disorders and associated abnormal
psychosocial situations among children and adolescents with JIA and to
evaluate their impact on and burden for their caregivers. Forty
subjects with JIA suffering for at least one year were included in the
study. Forty age- and sex-matched healthy subjects were included as
controls. Clinical psychiatric assessment was carried out blindly, and
psychiatric disorders and stressors on abnormal psychosocial situation
were assigned on the basis of ICD-10 clinical diagnoses of multiaxial
classification of child and adolescent psychiatric disorders.
Chronicity, distress, social impairment, and burden for others were
rated with the impact supplement of the strengths and difficulties
questionnaire (SDQ). Of the 40 cases of JIA, 24 were boys and 16 were
girls aged 10-18 years, with a mean age of 13.25 years. The frequency
of psychiatric disorders was 35% in the JIA and 12.5% in the
controlgroup (p <0.001). The long duration of illness was associated
with a higher proportion of cases with psychiatric disorders. In the
JIA group, the diagnoses in decreasing order were depressive disorder
(15%), somatoform disorder (12.5%), adjustment disorder (5%), and mixed
anxiety and depressive disorder (2.5%). Significantly higher stressors,
perceived difficulties, distress, social impairment, and burden for
caregivers were reported in the JIA group with psychiatric morbidity.
The presence of psychiatric disorders was associated with substantial
impairment of learning, peer relationship, and leisure activities.
Early psychiatric intervention might increase the likelihood of
satisfactory outcome of treatment in JIA