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AB1181 Psychological problems in saudi children with juvenile idiopathic arthritis is related to physical disability and disease status
  1. M.H. Salama1,2,
  2. M. Zaghloul1,2,
  3. E. Barakat1,3,
  4. H. Al Shrief4,
  5. M. Abdelfatah5
  1. 1Rheumatology, Saudi German Hospita, Jeddah, Saudi Arabia
  2. 2Rheumatology, Al-Azhar Faculity of Medicine Cairo, Egypt
  3. 3Rheumatology, Ain Sham Faculty of Medicine, Cairo, Egypt
  4. 4Psychatry
  5. 5Rheumatology, king Abd El azize hospital, Jeddah, Saudi Arabia

Abstract

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.

  1. Petty RE, Southwood TR, Baum J, et al.Revision of the proposed classification criteria for juvenile idiopathic arthritis. J. Rheumatol. 1998;25.

  2. Ravelli A, Viola S, Ruperto N, et al Correlation between conventional disease activity measures in juvenile chronic arthritis. Ann. Rheum. Dis. 1997;56.

  3. Brewer EJJ, Giannini EH Standard methodology for Segment I, II, and III Pediatric Rheumatology Collaborative Study Group studies. J. Rheumatol. 1982;9.

  4. Giannini EH, Ruperto N, Ravelli A, et al Preliminary definition of improvement in juvenile arthritis. Arthritis Rheum. 1997;40.

  5. Tennant A, Kearns S, Turner F, et al Measuring the function of children with juvenile arthritis. Rheumatology. 2001;40.

Disclosure of Interest None Declared

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