Depression in JIA Patients May Predict Long-term Pain and Disability, Study Finds

Vijaya Iyer, PhDby Vijaya Iyer, PhD

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Depression in JIA Patients May Predict Long-term Pain and Disability, Study Finds

In adolescents with juvenile idiopathic arthritis (JIA), high levels of depression at the time of their diagnosis may predict future pain and disability, according to researchers in the U.K.

Their study, “Depressive symptoms, pain and disability for adolescent patients with juvenile idiopathic arthritis: results from the Childhood Arthritis Prospective Study,” was published in the journal Rheumatology.

Limited mobility and difficulty in performing daily activities due to pain, fatigue, and disease unpredictability negatively impacts the health-associated quality of life in patients with JIA.

In this prospective study focused on adolescents with JIA in the U.K., researchers investigated the possible association of depressive symptoms with several clinical measures of the disease — such as pain, disability, joint inflammation, mobility, and the patient’s general evaluation of the disease.

The data was collected from the U.K. Childhood Arthritis Prospective Study (CAPS). In total, the study included 102 JIA patients (ages 11-16; median age 13.2). Researchers assessed data from the patients’ first visit to the rheumatologist (baseline time-point), and in follow-up visits.

The patient-reported depressive symptoms were scored using a mood and feelings questionnaire (MFQ). The MFQ score ranges from 0 to 66, and a score of 27 or higher indicates the presence of major depressive disorder (MDD).

Results of MFQ scores showed that, at baseline, major depressive disorder was observed in 14.7% of the patients analyzed.

Researchers also found that depression and all clinical measures of the disease analyzed at baseline were significantly associated.In addition, high levels of depression at baseline significantly predicted pain and disability outcomes in JIA patients one year after the diagnosis, but not active disease.According to the team, “the estimated active joint count and limited joint count for those with high and low depressive symptoms at baseline were not significantly different.”

“This study has shown for the first time that depressive symptoms are highly prevalent in adolescents with JIA in the U.K.,” researchers wrote. “This finding justifies actively screening for depressive symptoms in routine clinical practice.”

Given that worse disability and pain can negatively affect a patient’s lifestyle, quality of life, and mood, the team emphasized “the need for a psychological intervention study with the aim of improving long-term outcomes for adolescents with JIA.”

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