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Anxiety associates with pain and disability but not increased measures of inflammation for adolescent patients with juvenile idiopathic arthritis.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

Authors+Show Affiliations

University College London, Arthritis Research UK Centre for Adolescent Rheumatology, Room 422, Rayne Institute, 5 University St, London, WC1E 6JF.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, Division of Medicine, London.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, London.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, London.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, London.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, Division of Medicine, London.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, London.University College London Hospitals NHS Foundation Trust, Child and Adolescent Psychological Services, London.Queen Mary University of London, Department of Clinical Pharmacology, London.University College London, Arthritis Research UK Centre for Adolescent Rheumatology, Division of Medicine, London.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31199593

Citation

Hanns, Laura, et al. "Anxiety Associates With Pain and Disability but Not Increased Measures of Inflammation for Adolescent Patients With Juvenile Idiopathic Arthritis." Arthritis Care & Research, 2019.
Hanns L, Radziszewska A, Suffield L, et al. Anxiety associates with pain and disability but not increased measures of inflammation for adolescent patients with juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2019.
Hanns, L., Radziszewska, A., Suffield, L., Josephs, F., Chaplin, H., Peckham, H., ... Ioannou, Y. (2019). Anxiety associates with pain and disability but not increased measures of inflammation for adolescent patients with juvenile idiopathic arthritis. Arthritis Care & Research, doi:10.1002/acr.24006.
Hanns L, et al. Anxiety Associates With Pain and Disability but Not Increased Measures of Inflammation for Adolescent Patients With Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken). 2019 Jun 14; PubMed PMID: 31199593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anxiety associates with pain and disability but not increased measures of inflammation for adolescent patients with juvenile idiopathic arthritis. AU - Hanns,Laura, AU - Radziszewska,Anna, AU - Suffield,Linda, AU - Josephs,Francesca, AU - Chaplin,Hema, AU - Peckham,Hannah, AU - Sen,Debajit, AU - Christie,Deborah, AU - Carvalho,Livia A, AU - Ioannou,Yiannis, Y1 - 2019/06/14/ PY - 2019/6/15/entrez JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) N2 - OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/31199593/Anxiety_associates_with_pain_and_disability_but_not_increased_measures_of_inflammation_for_adolescent_patients_with_juvenile_idiopathic_arthritis L2 - https://doi.org/10.1002/acr.24006 DB - PRIME DP - Unbound Medicine ER -