[Psychological and social aspects of juvenile chronic arthritis]

Juvenile rheumatoid arthritis (JRA) affects the physical, psychological and social development of children and adolescents. Illness characteristics such as visibility, pain and uncertainty may influence the development of independence and social adjustment. Children can suffer from growth deficiencies, school problems, social isolation, sometimes psychopathology. International research does not yield consensus on the incidence of psychopathology in chronically ill children. The psychosocial effects of the illness are partly determined by the ways the child and the family react to the illness and its physical consequences. The functioning of child and family ultimately depends upon the balance between burdens and strengths. Reciprocal influences between illness and daily living can be understood through modern psycho-neuroimmunologic theories. These concepts ask for a multidisciplinary team-approach for suitable, individualized care.