The Functional and Psychological Outcomes of Juvenile Chronic Arthritis in Young Adulthood

Abstract

The functional and psychological outcome of 43 patients with polyarticular juvenile arthritis was assessed in order to evaluate the impact of disease on their quality of life. Mean disease duration was 19.7 yr (range 10-39 yr), mean age 26.7 yr (range 18-54 yr) with sex ratio 1:3 (male:female). Severe disability was present in 8% of systemic onset, 34% of RF negative (Rh-P), 38% of RF positive (Rh+P) and 86% of extended pauci-articular (ExP) juvenile arthritics-this last high percentage was due to ocular impairment. The Rh+P had more hip (100% of the group) and knee prostheses (31%) compared with Rh-P (77 and 11% respectively). The Rh+P and ExP groups were the most disabled with the highest proportions of patients with currently active disease (85 and 71% respectively). Psychological testing showed that 21% of the patients were clinically depressed and the rate increased (P = 0.06) with the degree of disability. The proportion of patients demonstrating an anxious preoccupation with their disease increased (P = 0.002) with the degree of disability. Despite this, 66% of patients were employed and 38% felt that their arthritis had no effect on their ability to form relationships.

Long-term outcome and prognosis in oligoarticular-onset juvenile idiopathic arthritis

“…As 1862 GUILLAUME ET AL already stated, although our results contradict the findings of many other studies (8,(11)(12)(13), this could be accounted for by important differences in patient selection and evaluation criteria. In this study, the oligoarticular-onset JIA outcome was evaluated in terms of eye and joint complications.…”

“…Finally, the prognosis of JIA has been studied with the use of different outcome measures, thus further contributing to diverging or even contradictory results (8,(11)(12)(13). Although the polyarticular course of oligoarticular-onset JIA has already been identified, together with joint destruction, as predictive of a poor outcome (8,9,(14)(15)(16), it has never been studied as an outcome measure itself, nor has uveitis occurrence despite having recently been shown to be associated with poor visual outcome in JIA and sarcoidosis in a large retrospective study of 582 cases of uveitis (17).…”

Proxy‐reported health‐related quality of life of patients with juvenile idiopathic arthritis: The pediatric rheumatology international trials organization multinational quality of life cohort study

“…Aasland et al (26) reported that long-term psychosocial outcome was favorable in most patients and that psychosocial functioning at followup was predicted by chronic family difficulties and correlated with physical disability, as measured by the CHAQ. A significant relationship between clinical depression and anxiety on psychological testing and the degree of disability was found by David et al (27). In a populationbased study, Peterson et al (28) reported that their JIA cohort perceived poorer health, less energy, more bodily pain, and more limitation in physical functioning compared with healthy children.…”

Is hydrotherapy cost-effective? A randomised controlled trial of combined hydrotherapy programmes compared with physiotherapy land techniques in children with juvenile idiopathic arthritis

“…Approximately one in every 1000 children and adolescents in the UK suffer from JIA, 1 around 30% of patients have active disease after 10 years and many have disability continuing into adulthood. [2][3][4][5][6] No curative treatment is available, but the anatomical, physiological and emotional abnormalities that occur as a direct result of disease 7 can be reduced or prevented in many cases. One treatment which may reduce the pathophysiological consequences of JIA is hydrotherapy.…”