Background When a child is diagnosed with JIA the following question arise: “How will the future be? Could I have a work, get a family”. One patient group, treated in 1982 at 15 yrs of age at the only specialized clinic in Sweden, Lund University Hospital, was followed up after 10 yrs. Later new kinds of pharmacological treatment were available, the question arise whether these affected psychosocial adjustment.
Objectives Could the new pharmalogical treatments affect adult functioning and psychosocial adjustment?
Methods Fifty-three patients (group 1) treated as inpatients at the Department for Pediatric Rheumatology, University Hospital in Lund 1982, 15 years of age, were followed up 1993-94. They were compared with a new group of patients (group 2) treated as inpatients 1996, and followed up 2010-2011. The same follow-up methods were used in both; semi-structured telephone-interviews including self-ratings questionnaires; HAQ, ISSI, SAS-SR and SCL-90-R. Both groups were similar in age and sex.
Results Group 2 had better functioning than group 1 according to HAQ (0.7±0.8 vs 1,2±0,8) and joint replacement was less common, (35% vs 60%). Further more full-time work was more common (53% vs 30%), and they were more often married (55% vs 34%), p <.05. The need of disability allowance has decreased, 28% vs 68%, as well as the need of support from significant others, 42% vs 64%. Both groups had few psychiatric symptoms (SCL-90-R) and a satisfying social network (ISSI).
Conclusions Patients in group 1 were almost adult before Methotrexate was used and biological treatment had not yet started when they were interviewed 1993-94. In group 2 many patients had been treated with Methotrexate almost from start and 38% were treated with biological drugs when they were interviewed. The financial costs for drugs are high but patients with early treatment cost less in healthcare and disability allowance, and they pay more tax to society, since they are more often working full-time. We consider the patient groups to be comparable at their initial treatment in Lund. The improved functioning and adjustment at follow-up could not be explained by differences in availability of support from society or educational possibilities.
Disclosure of Interest None declared
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