21. Adolescents with juvenile idiopathic arthritis experience lower levels of life event stress and trait anxiety than healthy adolescents

Abstract

Background: There are mixed reports as to whether juvenile idiopathic arthritis (JIA) patients have impaired psychological health (table parsented) when compared to healthy children or not. Additionally, this has never been explored in a purely adolescent population of JIA patients and healthy adolescents. Aims: To compare the psychological health of adolescent patients with JIA to that of healthy adolescents. Methods: 145 JIA patients aged 13-18 years were recruited from University College Hospital, London and 88 age and gender matched adolescent healthy controls were recruited from local high schools. All participants gave informed consent. All participants completed a questionnaire pack assessing anxiety (State-Trait Anxiety Inventory), low mood (Short Mood and Feelings Questionnaire - Child Version), stressful life events (Coddington Life Events Scale), resilience (Resilience Scale) and wellbeing (Warwick and Edinburgh Mental Wellbeing Scale). For JIA patients, disease activity measures were also recorded on the same day of questionnaire completion. Data were analysed using the Spearman's Rank Correlation Coefficient, Mann Whitney and Chi squared. Results: Demographic, psychological and clinical data for adolescent JIA patients and adolescent healthy controls are summarized in table 1. We found that JIA patients had significantly lower stressful life events scores (p < 0.05) and lower state anxiety scores (p < 0.05) than healthy age and gender matched adolescents (table 1). There were no other significant differences between JIA patients and healthy controls for depressive symptoms, trait anxiety, wellbeing and resilience scores. There was no significant difference between the proportion of patients and healthy adolescents scoring over the Mood and Feelings Questionnaire cut-off for probable depression (>8 points). Conclusions: We found adolescents with JIA have the same levels of depressive symptoms, state anxiety, resilience and wellbeing as healthy adolescents, disproving the hypothesis that teenagers with JIA have worse psychological health than their healthy peers. Indeed, JIA patients experienced lower levels of life event stress and trait anxiety than healthy adolescents, though this may be because of the significant lifestyle limitations experienced as a result of their disease.