Psychological functioning of children and adolescents with juvenile idiopathic arthritis is related to physical disability but not to disease status
Psychological functioning of children and adolescents with juvenile idiopathic arthritis is related to physical disability but not to disease status
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DOI：
10.1093/rheumatology/ken095
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发表时间：
2008-05-01
期刊：
影响因子：
5.5
通讯作者：
David, J.
中科院分区：
文献类型：
--
作者：
Ding, T.;Hall, A.;David, J.
目标。本研究调查了多关节疾病儿童的心理功能及其与疾病活动性和致残性的关系。60名7-18岁患有幼年特发性关节炎和4个关节受累的儿童被纳入研究。孩子们接受了体检。童年HAQ是由孩子和他们的父母共同完成的。儿童还完成了关于抑郁(Birleson Depression Inventory；BDI)、焦虑(修订后的儿童表现焦虑量表；RCMAS)以及同伴、情绪和行为问题(优点和困难问卷；SDQ)的问卷调查。从医院病历中提取临床信息。自我报告的心理功能(抑郁、焦虑和行为)与正常人群没有什么不同。父母报告的SDQ上的情绪困难有所上升。在评估时，心理功能与医生评定的疾病活动评分或活跃关节的数量之间没有显著的相关性。此外，在有或没有显著升高的炎症标志物的儿童之间，没有发现心理功能的差异。心理功能各维度(抑郁、焦虑、行为)与躯体功能呈中度相关(r(S)分别为0.49、0.41、0.46，P均<0.01)。患有多发性关节炎的儿童和青少年患心理困难的风险并没有显著增加。较差的心理结果与更严重的身体残疾有关，但与疾病活动的水平无关。
Objectives. This study investigates the psychological functioning of children with polyarticular joint disease and its association with disease activity and disability.Methods. Sixty children aged 7-18 yrs with juvenile idiopathic arthritis and >4 joints involved were recruited. Children underwent a physical examination. The Childhood HAQ was completed by both the children and their parents. Children also completed questionnaires for depression (Birleson Depression Inventory; BDI), anxiety (Revised Childrens Manifest Anxiety Scale; RCMAS) and peer, emotional and behavioural problems (Strengths and Difficulties Questionnaire; SDQ). Clinical information was extracted from the hospital records.Results. Self-reported psychological functioning (depression, anxiety, and behaviour) was not different from the normal population. Parent-reported emotional difficulties on the SDQ were somewhat elevated. There were no significant correlations between psychological functioning and physician-rated disease activity score or the number of active joints at the time of assessment. Furthermore, no differences in psychological functioning were found between children with or without significantly raised inflammatory markers. All aspects of psychological function (depression, anxiety and behaviour) correlated moderately with physical function (r(s) = 0.49, 0.41, 0.46, respectively; all P < 0.01).Conclusions. Children and adolescents with polyarthritis are not at significantly elevated risk of psychological difficulties. Poor psychological outcome was associated with more severe physical disability but not with the level of disease activity.