Symptoms and correlates of depression and anxiety in children and adolescents with juvenile idiopathic arthritis

Abstract

Objective: Juvenile idiopathic arthritis (JIA) can impair physical functioning and increase psychological burden. This study aimed to examine factors associated with clinically relevant depression and anxiety symptoms, and to describe the prevalence of clinically relevant depression and anxiety symptoms in children and adolescents with JIA. Methods: We conducted a prospective cross-sectional study from July 2020 to June 2022 among JIA patients aged 8‒17 years at the largest university-based tertiary hospital in Bangkok, Thailand. Clinically relevant depression and anxiety symptoms were measured using the Children’s Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders (SCARED). Results: Eighty-seven patients (50 males, 37 females) with a median age of 12.6 (IQR 9.8‒14.4) years were enrolled. The median disease duration was 38 (IQR 10‒67) months, and 61 (70.1%) exhibited clinically inactive disease. Nine (10.3%) had clinically relevant depressive symptoms, while 45 (51.7%) had clinically relevant anxiety symptoms. Among these 45, 34 (75.6%) exhibited separation anxiety, 16 (35.6%) social anxiety, 15 (33.3%) school anxiety, 6 (13.3%) panic symptoms, and 6 (13.3%) generalized anxiety. CDI scores were significantly correlated with SCARED scores (r = 0.519, P < 0.001). Multiple linear regression revealed that biologic therapy was associated with clinically relevant depressive symptoms (standard β = 0.353, 95%CI 3.064–13.286, P = 0.002), whereas disability was associated with clinically relevant anxiety symptoms (standard β = 0.325, 95%CI 0.998-10.153, P = 0.018). Conclusions: Symptoms of depression and anxiety were common even in JIA patients with clinically inactive disease. Routine mental health screening should be integrated into clinical care.