Objectives This study aimed at investigating the psychological functioning of Saudi children with poly-articular joint disease and its association with disease activity and disability.
Methods One hundred and twenty Saudi children aged 6-16 years, with juvenile idiopathic arthritis and more than 4 joints involved were recruited. All Children were classified according to the revised World Health Organization ILAR classificationAll Children underwent a clinical examination. Clinical information was extracted from the hospital records. Disease activity was measured by:1- active joints count,2- visual analogue score and 3- serological markers of inflammation, such as Erythrocyte sedimentation rate (ESR) and C-Reactive protein (CRP) were measured. We chose a cut-off level of ESR more than 30 mm/h and CRP more than 30 mg/dl as a significant level of inflammation. Parents were asked to sign a consent form and the children provided verbal consent. The Childhood HAQ (childhood health assessment questionnaire) was completed by both the children and their parents.Children also completed questionnaires for; 1- depression (Birleson Depression Inventory; BDI), 2- anxiety (Revised Children’s Manifest Anxiety Scale; RCMAS)and 3- peer, emotional and behavioral problems (Strengths and Difficulties Questionnaire); (SDQ).
Results The sample studied showed that, Self-reported psychological functioning (depression, anxiety, and behavior) was not different from the normal population. No differences in psychological functioning were found between Saudi children with or without raised inflammatory markers (ESR/CRP). Parent-reported emotional difficulties on the (Strengths and Difficulties Questionnaire) SDQ, were somewhat elevated. There were no significant correlations between psychological functioning and physician-measured disease activity score or the number of active joints at the time of all aspects of psychological function (depression, anxiety and behavior) correlated significantly with physical function; (all p<0.01).
Conclusions Children with poly-arthritis are not at significantly elevated risk of psychological difficulties. Poor psychological problems were associated with more severe physical disability but not with the level of disease activity.
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Disclosure of Interest None Declared
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