Evaluation of psychosocial aspects in patients with juvenile idiopathic arthritis

Abstract

The relationship between psychological factors and the overall health of patients with Juvenile Idiopathic Arthritis (JIA) is evident, yet the specific impact of the presence of Temporomandibular Joint (TMJ) signs or symptoms is not fully understood. This article seeks to elucidate the current knowledge of the relationship between TMJ signs and symptoms, psychosocial factors, and broader clinical manifestations in JIA patients. To investigate this relationship further, the present article will also present the results of a study including a total of 73 JIA patients, consisting of 56 females and 17 males (mean age 12.2 ± 2.8 years old; range 6–16). These patients were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). Self-reported questionnaires were used to investigate the psychosocial aspects of stress, anxiety, depression, and catastrophizing. General quality of life and disease activity were assessed with the JAMAR questionnaire (Juvenile Arthritis Multidimensional Assessment Report). For inferential statistics, the Pearson r coefficient, linear regression models and T test for unpaired data were used. The level of significance was P<0.05. Increased general disease activity and significant impacts on quality of life were associated with increased psychological distress. The four psychosocial factors examined, including anxiety, stress, catastrophizing, and depression, all had a negative impact on the quality of life, symptomatology, and disease activity. Specifically, anxiety and catastrophizing influenced the relationship between the presence of symptoms and the reported quality of life where higher levels of anxiety and catastrophizing increased the impact of the symptoms on the quality of life. Finally, the presence of TMJ signs and/or symptoms did not exacerbate the psychosocial domains but affected the functional aspect of the patient.