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Prevalence of Depression in Patients with Juvenile Idiopathic Arthritis Presenting at a Tertiary Care Hospital
Saira Bano1, Khalid Bosan2, Sadia Khurshid1
1Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, PAK.
Insights
A study on juvenile idiopathic arthritis (JIA) found a high prevalence of depression in affected children in Pakistan. Depression was linked to increased physical disability, highlighting the need for early intervention to improve patient outcomes.
Area of Science:
- Pediatrics
- Rheumatology
- Psychiatry
Background:
- Juvenile idiopathic arthritis (JIA) is a childhood autoimmune rheumatic disease.
- JIA is associated with significant psychological distress, including depression, impacting quality of life.
Purpose of the Study:
- To determine the prevalence of depression in children with JIA.
- To investigate the association between depression and physical disability in JIA patients.
Main Methods:
- A cross-sectional study involving 100 children diagnosed with JIA.
- Assessed physical disability using the Childhood Health Assessment Questionnaire disability index (CHAQ-DI).
- Measured depression using the Center for Epidemiological Studies Depression Scale for Children (CES-DC).
Main Results:
- 72% of JIA patients exhibited significant depression.
- Depression severity correlated with physical disability (mild, moderate, severe).
- Age was a significant factor associated with depression in JIA patients.
Conclusions:
- The prevalence of significant depression is notably high among children with JIA in the studied population.
- Early detection and intervention for depression are crucial for managing JIA and reducing patient morbidity.
- Findings underscore the importance of integrated care addressing both physical and mental health in pediatric rheumatology.
Abstract:
Background and objective Juvenile idiopathic arthritis (JIA) is an idiopathic autoimmune rheumatic disorder in children. JIA has been associated with depression and has a negative psychological impact on patients' quality of life. The aim of the study is to determine the prevalence of depression in patients with JIA presenting at a tertiary care hospital in Islamabad, Pakistan. Materials and methods This cross-sectional study, conducted at the Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, included 100 children aged >6 years who had been diagnosed with JIA according to the 2004 revised International League of Associations for Rheumatology classification. Physical disability was measured using the Childhood Health Assessment Questionnaire disability index (CHAQ-DI), whereas depression was assessed by measuring their Center for Epidemiological Studies Depression Scale for Children (CES-DC) scores. Results were analyzed using IBM SPSS Statistics for Windows, Version 20.0. (Armonk, NY: IBM Corp.), with p-values ≤ 0.05 considered statistically significant. Results The 100 patients included 54 male patients (mean age, 16.3 ± 4.9 years) and 46 female patients (mean age, 18.6 ± 5.1 years). CES-DC scores showed that 72 patients with JIA had significant depression. Of these 72 patients, 50 (69.4%) had mild, 21 (29.2%) had moderate, and one (1.4%) had severe disability according to CHAQ-DI criteria. Age was the only effect modifier significantly associated with significant depression in patients with JIA (P < 0.05). Conclusion A cross sectional survey was carried out to find prevalence of depression in children with JIA. Physical disability and depression were measured using standardized tools. The percentage of significant depression among children with JIA is very high in our local population and was significantly associated with disease severity. Our findings emphasize the need to initiate early and prompt measures to prevent depression and reduce overall morbidity in patients with JIA.
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