Anxiety and depression symptoms in adolescents and young adults with juvenile idiopathic arthritis: results of an outpatient screening

被引:5
作者
Milatz, Florian [1 ]
Klotsche, Jens [1 ]
Niewerth, Martina [1 ]
Sengler, Claudia [1 ]
Windschall, Daniel [2 ,20 ]
Kallinich, Tilmann [3 ,4 ,5 ,21 ]
Dressler, Frank [6 ]
Trauzeddel, Ralf [7 ]
Holl, Reinhard W. [8 ,22 ]
Foeldvari, Ivan [9 ]
Brueck, Normi [10 ]
Temming, Svenja [3 ,4 ,5 ]
Hospach, Toni [11 ]
Warschburger, Petra [12 ]
Berendes, Rainer [13 ]
Erbis, Gabriele [14 ]
Kuemmerle-Deschner, Jasmin B. [14 ]
Weller-Heinemann, Frank [15 ]
Haas, Johannes-Peter [16 ]
Mueller-Stierlin, Annabel S. [17 ]
Mutter, Agnes [18 ]
Meissner, Thomas [19 ]
Baumeister, Harald [18 ]
Minden, Kirsten [1 ,3 ,4 ]
机构
[1] Deutsch Rheuma Forschungszentrum Julich Berlin, Inst Leibniz Gemeinschaft, Programme Area Epidemiol, Hlth Serv Res, Charitepl 1, D-10117 Berlin, Germany
[2] St Josef Stift Sendenhorst, Northwest German Ctr Rheumatol, Clin Paediat & Adolescent Rheumatol, Sendenhorst, Germany
[3] Charite Univ Med Berlin, Dept Paediat Resp Med Immunol & Crit Care Med, Berlin, Germany
[4] Free Univ Berlin, Berlin, Germany
[5] Humboldt Univ, Berlin, Germany
[6] Hannover Med Sch, Childrens Hosp, Dept Paediat Pneumol Allergol & Neonatol, Hannover, Germany
[7] HELIOS Klin, Dept Paediat Paediat & Adolescent Rheumatol, Berlin, Germany
[8] Univ Ulm, Inst Epidemiol & Med Biometry, ZIBMT, Ulm, Germany
[9] Schon Klin Hamburg Eilbek, Hamburg Ctr Paediat & Adolescent Rheumatol, Hamburg, Germany
[10] Tech Univ Dresden, Carl Gustav Carus Univ Hosp, Dept Paediat, Dresden, Germany
[11] Klinikum Stuttgart, Dept Paediat, Olgahos, Stuttgart, Germany
[12] Univ Potsdam, Dept Psychol, Potsdam, Germany
[13] Childrens Hosp St Marien, Pediat Rheumatol, Landshut, Germany
[14] Univ Hosp Tuebingen, Autoinflammat Reference Ctr Tuebingen arcT, Dept Pediat, Div Pediat Rheumatol,ERN RITA, Tubingen, Germany
[15] Klinikum Bremen Mitte, Eltern Kind Zentrum Prof Hess, Dept Pediat & Adolescent Med, Pediat Rheumatol, Bremen, Germany
[16] German Ctr Paediat & Adolescent Rheumatol, Garmisch Partenkirchen, Germany
[17] Ulm Univ, Dept Psychiat & Psychotherapy 2, Ulm, Germany
[18] Ulm Univ, Inst Psychol & Educ, Fac Engn Comp Sci & Psychol, Dept Clin Psychol & Psychotherapy, Ulm, Germany
[19] Heinrich Heine Univ, Univ Hosp Dusseldorf, Med Fac, Dept Gen Paediat Neonatol & Paediat Cardiol, Dusseldorf, Germany
[20] Univ Halle Wittenberg, Med Fak, Halle, Germany
[21] Deutsch Rheuma Forschungszentrum Julich Berlin, Inst Leibniz Gemeinschaft, Programme Area Syst Rheumatol, Berlin, Germany
[22] German Ctr Diabet Res DZD, Munich, Germany
关键词
Internalizing symptoms; Depression; Anxiety; Mental health; Juvenile idiopathic arthritis; Adolescents; Screening; QUALITY-OF-LIFE; DISEASE-ACTIVITY; HEALTH; CHILDREN; DISORDER; PAIN; DISABILITY; CLASSIFICATION; IMPACT; GAD-7;
D O I
10.1186/s13075-024-03312-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Previous studies have shown that growing up with rheumatic conditions can fuel dissatisfaction and psychological distress, which in turn affects disease self-management and treatment adherence. Primary objective of this study was to estimate the prevalence of anxiety and depression symptoms in adolescents and young adults (AYA) with juvenile idiopathic arthritis (JIA) and to identify correlates of conspicuous screening results. Methods Initiated as part of the COACH multicenter observational study, outpatients aged 12 to 21 years participating in the National Pediatric Rheumatological Database (NPRD) were prospectively screened for mental health using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder Scale-7 (GAD-7). Results Data from 1,150 adolescents with JIA (mean age 15.6 +/- 2.2 years; mean disease duration 7.2 +/- 4.9 years, 69% female, 43% oligoarthritis, 26% polyarthritis) were analysed. Overall, 32.7% (n = 316) of AYA showed conspicuous screening results, of whom 30.4% reported clinically relevant suicidal or self-harm thoughts. About 19% of screened patients showed moderate to severe depressive or anxious symptoms. AYA with conspicuous screening results were older (15.8 vs. 15.2 years; p < 0.0001), more often female (81% vs. 64%; p < 0.0001) and more often overweight (25% vs. 17%; p = 0.006). They had higher disease activity (physician global assessment on NRS 0-10; 1.7 vs. 1.2; p < 0.0001), more functional limitations (CHAQ; 0.44 vs. 0.14; <0.0001) and rated their health status worse (NRS 0-10; 3.5 vs. 1.8; p < 0.0001) than AYA with inconspicuous screening results. Females (OR 2.33 [CI 1.53-3.56]; p < 0.0001), older age (OR 1.09 [CI 1.01-1.18]; p = 0.026), patients with more functional limitations (OR 3.36 [CI 1.98-5.72]; p < 0.0001), and patients with worse subjective health status (OR 1.17 [CI 1.07-1.27]; p < 0.0001) were more likely to have a conspicuous screening result. Regular sports participation was associated with a lower likelihood of conspicuous screening result (OR 0.69 [CI 0.49-0.98]; p = 0.039). Conclusions A large-scale outpatient screening of AYA with JIA in Germany shows a high prevalence of anxiety and depression symptoms. The need for routine screening for early detection of mental health problems became apparent.
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