&lt;p&gt;Depression And Anxiety In Patients With Juvenile Idiopathic Arthritis: Current Insights And Impact On Quality Of Life, A Systematic Review&lt;/p&gt;

Fair, D.; Rodriguez, Martha; Knight, Andrea; Rubinstein, Tamar

doi:10.2147/oarrr.s174408

Cited by 81 publications

(85 citation statements)

References 76 publications

(214 reference statements)

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“…We also found that HRQOL domains are themselves interrelated, characterized by the finding that patients reporting symptoms of depression tended also to report symptoms of anxiety. Gender differences are similar to those previously reported [reviewed in reference [ 3 ]. We found that reporting of pain interfering with daily activities was associated with reporting symptoms of depression, similar to previous studies showing pain itself to be associated with depressive symptoms [ 3 , 4 , 6 ].…”

Section: Discussionsupporting

confidence: 91%

“…Gender differences are similar to those previously reported [reviewed in reference [ 3 ]. We found that reporting of pain interfering with daily activities was associated with reporting symptoms of depression, similar to previous studies showing pain itself to be associated with depressive symptoms [ 3 , 4 , 6 ]. Another domain associated with increased depressive symptoms was difficulty with peer relationships (the wording of questions in PROMIS results in inverse scoring).…”

Section: Discussionsupporting

confidence: 91%

“…Children with JIA are at risk of developing long-term disability from continued disease activity and may experience difficulty with health related quality of life (HRQOL) and [ 2 ]. JIA has been associated with such HRQOL related problems as emotional difficulties (social isolation, depression, and anxiety), pain, and decreased physical function [ 3 , 4 ]. Problems with HRQOL have been associated with more severe pain and more limited mobility [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Use of PROMIS® to screen for depression in children with arthritis

et al. 2020

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Background Children with JIA may experience difficulty with health related quality of life (HRQOL). The Patient Reported Outcomes Measurement Information System (PROMIS) a patient related outcome (PRO) measure, covers HRQOL domains that include physical function, mental health, and social interactions. During initial use, we found PROMIS identified children with symptoms of depression, sometimes before they shared those feelings with parents or members of the clinic team. We studied the use of PROMIS for this purpose, and to determine what demographic, clinical, and other characteristics might be related to higher depressive symptom scores. Methods From March 2014 – February 2017, at each visit, all JIA patients having met ILAR classification criteria seen by M.L.M. received the PROMIS Short Form 35 v.1.0, as part of routine care. T scores were calculated from raw scores for mobility, anxiety, depressive symptoms, fatigue, peer relationships, and pain interference domains. Data extracted by optical mark recognition software were merged with electronic medical record (EMR data), extracted by Extract/Transform/Load software, including joint counts, visit age, ANA, RF, and HLA-B27 status. Mixed effects models were used to identify significant associations of independent variables with depression T scores. Results Data from 148 patients were analyzed (114 females for 435 visits, 34 males for 118 visits; 13.8 ± 2.8 years): 70 persistent oligoarthritis, 9 extended oligoarthritis, 19 ERA, 21 polyarthritis (RF-), 5 polyarthritis (RF+), 11 undifferentiated arthritis, 3 psoriatic arthritis, 10 systemic arthritis). T scores showed wide ranges within individual JIA categories, with similar mean scores for all groups. Univariate linear mixed effects models showed significant relationships to depression T scores of gender and race (males and Asian patients with lower T scores, p < .0001, p = 0.091, respectively), joint count (p = 0.002), pain interference score (p = 0.0004), and Patient and Physician Global Assessment (p = 0.004, p < .0001, respectively). No particular JIA category was associated with Depression T scores. HRQOL domains were interrelated (p < .0001), including patients reporting symptoms of depression tending also to report symptoms of anxiety. PROMIS identified 15 patients who did not otherwise report depressive symptoms, but needed referral for counseling; eight did not endorse depressive symptoms until the 2nd or 3rd visit. Only 3 patients had disease flare. Concerns besides arthritis such as parental conflict or school bullying were elicited in 7 patients during interviews with the social worker. All patients expressed being worried about their arthritis. Conclusion PROMIS is useful in screening JIA patients for symptoms of depression, particularly to identify patients who might not otherwise report these symptoms. The other PROMIS domain scores are related to reporting of symptoms of depression, as is Patient and Physician Global Assessment. Future studies will use PROMIS questionnaires incorporated into the EMR, permitting data entry by tablets and an online patient portal. This will make possible comparisons of HRQOL in children with JIA to those with other chronic rheumatic and non-rheumatic diseases.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Use of PROMIS® to screen for depression in children with arthritis

et al. 2020

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“…The task force also recognized the increased prevalence of anxiety and depression in patients with PRD as compared to the general population (27–29) and addressed concerns about additional emotional distress related to the COVID‐19 pandemic (30). Rheumatology providers should be aware of the heightened emotional burden posed by the pandemic, including fears of becoming infected, having a family member infected, potential risks from medications, concerns about social isolation, and potential financial hardships.…”

Section: Resultsmentioning

confidence: 99%

American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID‐19 Pandemic: Version 1

Wahezi

Rubinstein

et al. 2020

Arthritis & Rheumatology

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Objective To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID‐19) pandemic. Methods The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9‐point numeric scoring system with predefined levels of agreement (categorized as disagreement, uncertainty, or agreement, with median scores of 1–3, 4–6, and 7–9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus. Results The task force drafted 33 guidance statements, which were voted upon during the second and third rounds of voting. Of these 33 statements, all received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 6) or high consensus (n = 27). Statements with similar recommendations were combined, resulting in 27 final guidance statements. Conclusion These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS–CoV‐2 infection. This guidance is presented as a “living document,” recognizing that the literature on COVID‐19 is rapidly evolving, with future updates anticipated.

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“…Depressive symptoms among these children may be conditioned by their restricted daily activities, altered body images, growth retardation, visual symptoms, limitations in leisure time, and frequent visits to the doctor [11]. Psychological problems, especially depression, are more prevalent in patients with JIA than in normal individuals, with the incidence of clinically significant depression ranging from 7% to 36% in children with JIA [12][13][14]. To further assess the incidence of this commonly occurring psychological disorder in patients with JIA, and to better understand the significant effect modifiers associated with the increased prevalence of depression in these patients, the present study assessed the burden of depression in JIA patients in the local population of Islamabad, Pakistan.…”

Section: Introductionmentioning

confidence: 99%