Children with juvenile idiopathic arthritis: are health outcomes better for those diagnosed younger?
Summary of "Children with juvenile idiopathic arthritis: are health outcomes better for those diagnosed younger?"
Backgroundâ Children living with juvenile idiopathic arthritis (JIA) have swollen, painful and stiff joints, which may have an impact on all spheres of their life, as well as their family. While children diagnosed in their preschool years may be at risk for worse physical outcomes than children diagnosed later in life, it is not clear whether they have worse psychological outcomes and whether these outcomes have an impact on their everyday life. The aim of this study was to examine the association between age at diagnosis and health outcomes in families of children with JIA. Methodsâ Parents of children with JIA (nâ=â182) who attended rheumatology clinics at the Montreal Children's Hospital and British Columbia Children's Hospital completed measures assessing socio-demographic attributes, their child's health status, health-related quality of life and pain level, as well as their own level of psychological distress and coping behaviours. Regression models explored the association between age at diagnosis and health outcomes while adjusting for sex, age, severity and duration of the disease. Resultsâ Parents of children diagnosed with JIA before 5 years of age found their child to have a better health-related quality of life in terms of psychosocial functioning than parents of children diagnosed later [ÎČâ=â-0.91 (-1.63, -0.19)]. Children diagnosed younger were also found to be less limited in schoolwork or activities with friends because of emotional or behavioural problems than children diagnosed later [odds ratioâ=â0.07 (0.01, 0.42)]. Conclusionsâ Children diagnosed younger seem to show good psychosocial adjustment, which may also be true for their caregivers. Perhaps more attention to psychosocial adjustment should be given to families of children who are diagnosed with the disease at an older age.
Affiliation
Department of Epidemiology and Community Medicine, University of Ottawa Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, ON Département de médecine sociale et préventive and Institut de recherche en santé publiqu
Journal Details
This article was published in the following journal.
Name: Child: care, health and development
ISSN: 1365-2214
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22676178
- DOI: http://dx.doi.org/10.1111/j.1365-2214.2012.01386.x
Medical and Biotech [MESH] Definitions
Arthritis, Juvenile Rheumatoid
Rheumatoid arthritis of children occurring in three major subtypes defined by the symptoms present during the first six months following onset: systemic-onset (Still's Disease, Juvenile-Onset), polyarticular-onset, and pauciarticular-onset. Adult-onset cases of Still's disease (STILL'S DISEASE, ADULT-ONSET) are also known. Only one subtype of juvenile rheumatoid arthritis (polyarticular-onset, rheumatoid factor-positive) clinically resembles adult rheumatoid arthritis and is considered its childhood equivalent.
Macrophage Activation Syndrome
A serious complication of childhood systemic inflammatory disorders that is thought to be caused by excessive activation and proliferation of T-LYMPHOCYTES and MACROPHAGES. It is seen predominantly in children with systemic onset JUVENILE IDIOPATHIC ARTHRITIS.
Juvenile Literature
Works produced for children through age 15 or through the ninth grade.
Hla-dr4 Antigen
Human immune-response, D-related antigen encoded by the D locus on chromosome 6 and found on lymphoid cells. It is strongly associated with rheumatoid arthritis and juvenile diabetes.
Hla-dr5 Antigen
Human immune-response, D-related antigen encoded by the D-locus on chromosome 6 and found on lymphoid cells. It is associated with Kaposi sarcoma in AIDS and juvenile rheumatoid arthritis.
PubMed Articles
ABSTRACT: Recently, the Food and Drug Administration placed a "black box" label on etanercept, and other tumor necrosis factor inhibitors used to treat childhood arthritis, warning of the risk of mali...
The association between nephrotic syndrome and juvenile idiopathic arthritis have rarely been described in pediatric patients. We report a child with steroid-responsive nephrotic syndrome, with freque...
To examine the safety and efficacy of the interleukin-1 (IL-1) receptor antagonist anakinra as first-line therapy for systemic juvenile idiopathic arthritis (JIA).
Factors associated with treatment response to etanercept in juvenile idiopathic arthritis.
Since the introduction of biologic therapies, the pharmacological treatment approach for juvenile idiopathic arthritis (JIA) has changed substantially, with achievement of inactive disease as a realis...
DEK is a nuclear phosphoprotein and autoantigen in a subset of children with juvenile idiopathic arthritis (JIA). Autoantibodies to DEK are also found in a broad spectrum of disorders associated with...
Clinical Trials
Trial of Early Aggressive Drug Therapy in Juvenile Idiopathic Arthritis
The purpose of this study is to compare two aggressive drug regimens for children with poly-juvenile idiopathic arthritis (JIA) and extended oligo JIA.
This is a multicenter, Phase 3 randomized, placebo-controlled study designed to evaluate adalimumab in subjects with polyarticular juvenile idiopathic arthritis (JIA) who are either methot...
Efficacy and Safety of Growth Hormone Treatment in Juvenile Idiopathic Arthritis
Growth retardation is well known in patients with severe forms of juvenile idiopathic arthritis. Especially those who were under additional treatment with glucocorticoids for high disease...
A Study of Tocilizumab in Patients With Active Systemic Juvenile Idiopathic Arthritis
This study will evaluate the efficacy and safety of tocilizumab in patients with active systemic juvenile idiopathic arthritis (sJIA) who have an inadequate clinical response to NSAIDs and...
Aggressive Combination Drug Therapy in Very Early Polyarticular Juvenile Idiopathic Arthritis
The objective of this study is to compare in very early polyarticular juvenile idiopathic arthritis (JIA) the efficacy, safety, and cost-benefit-ratio of three treatment strategies: biolog...