In a new study, researchers say they have found a clear association between depression and the level of disease activity and disability in adolescent patients with juvenile inflammatory arthritis, the most common chronic pediatric rheumatic disease.
The results, presented at the European League Against Rheumatism Annual Congress (EULAR 2016) June 8-11 in London, highlight the need for continuous psychological support in adolescents with juvenile inflammatory arthritis.
“We already know there is an association between depression and disease severity in rheumatoid arthritis. Children with juvenile inflammatory arthritis have also been shown to have depression, and this is associated with disability,” said Dr. John Ioannou, study lead author from University College London in England. “However, there has been much less work looking at depression in adolescents with juvenile inflammatory arthritis.
“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 juvenile inflammatory arthritis,” he said.
In this study, performed with U.K. nationwide cohorts, a team of researchers, including Laura Hanns, who undertook the study as her Ph.D. project, found that within a population of 102 adolescents with juvenile inflammatory arthritis, one in seven patients displayed significant symptoms of depression. Patients were recruited to the Childhood Arthritis Prospective Study within six months of disease onset.
Measuring the level of depression using the using the Mood and Feelings Questionnaire (MFQ, composed of a series of descriptive phrases regarding how the subject has been feeling or acting recently), authors observed a positive correlation between depression and disease severity: Patients with high levels of depressive symptoms were also those exhibiting more joints with restricted movement, a higher disease severity, more pain and more disability. Within the first 12 months of treatment, these symptoms declined rapidly and stabilized.
After the first year of treatment, depressive symptoms were no longer associated with future inflamed joint count, restricted joint count, and patient rating of disease severity. Rather, the association was maintained with future higher levels of ongoing disability and pain.
Previous epidemiological studies reported that the general population of adolescents has a much lower level for the prevalence of depression than the adolescents with juvenile inflammatory arthritis in this study.