Anxiety associates with pain and disability but not increased measures of inflammation for adolescent patients with juvenile idiopathic arthritis.Arthritis Care Res (Hoboken) 2019AC
To explore whether anxiety and depression associate with clinical measures of disease for adolescent JIA patients. To explore whether anxiety and depression associate with increased peripheral pro-inflammatory cytokine levels in adolescent JIA patients and in healthy adolescent controls.
136 patients with JIA and 88 healthy controls aged 13-18 completed questionnaires on anxiety and depressive symptoms. For JIA patients, pain, disability, physician visual analogue scale (VAS) and number of joints with active inflammation (active joint count) were recorded. In a sub-sample, we assessed lipopolysaccharide-stimulated IL-6 production from peripheral blood mononuclear cells, serum IL-6, cortisol and C-reactive protein (CRP) levels. Data were analysed by linear regression analysis.
Levels of anxiety and depressive symptoms for JIA patients were not significantly different to healthy controls. For JIA patients, anxiety significantly associated with disability (β=0.009, p=0.002), pain (β=0.029, p=0.011) and physician VAS (β=0.019, p=0.012), but not active joint count (β=0.014, p=0.120). Anxiety did not associate with any laboratory measures of inflammation for JIA patients. These relationships were also true for depressive symptoms. For healthy controls, anxiety (but not depressive symptoms) showed a trend towards an association with stimulated IL-6 (β=0.004, p=0.052).
Adolescent JIA patients experience equivalent levels of anxiety and depressive symptoms as healthy adolescents. For adolescent JIA patients, anxiety and depressive symptoms associate with pain, disability and physician VAS but not with inflammation. This article is protected by copyright. All rights reserved.