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Children with juvenile idiopathic arthritis: are health outcomes better for those diagnosed younger?

22:21 EDT 25th May 2013 | BioPortfolio

Summary of "Children with juvenile idiopathic arthritis: are health outcomes better for those diagnosed younger?"

Background  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. Methods  Parents of children with JIA (n = 182) 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. Results  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 [ÎČ = -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 ratio = 0.07 (0.01, 0.42)]. Conclusions  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:

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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.

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