MENTAL HEALTH DISORDERS IDENTIFICATION IN PEDIATRIC PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS WITH CHRONIC PAIN SYNDROME

Abstract

Mental health disorders in pediatric rheumatologists’ practice are often unrecognized and insufficiently taken into account by pediatric rheumatologists when managing patients suffering from juvenile idiopathic arthritis (JIA). The chronic pain syndrome, which complicates the course of JIA, largely has a psychosomatic basis and is associated both with the severity of mental disorders in the patients themselves and with the characteristics of parent-child relationships. The purpose of the research was to study the severity of manifestations of mental disorders, emotional regulation and parent-child relationships in pediatric patients with JIA with chronic pain syndrome in comparison with patients with acne. Materials and methods used: a single-center simultaneous study of adolescents aged 11 to 17 y/o was conducted in Oct.-Dec. 2022. Using a visual analogue scale, the severity of pain was assessed separately by the participants in the study and their parents; patients assessed their general condition, whilst the physician determined the overall assessment of the current activity of the disease. All of the participants had completed the Difficulties in Emotion Regulation Scale (DERS), Parental bonding instrument (PBI) and Strengths and Difficulties Questionnaire (SDQ) questionnaires. Results: the main group consisted of 30 suffering from JIA with chronic pain syndrome. The comparison group consisted of 40 with acne. In patients with JIA, the values in the scales “Behavioral problems” (p=0.001), “Hyperactivity” (p=0.001), “Problems with peers” (p=0.001), “Emotional detachment” (assessment of mothers and fathers, p=0.001) and “Hyper care” (assessment of mothers and fathers, p=0.001) were statistically significantly lower, whilst higher in the values for “Prosocial behavior” (p=0.026), “Awareness of own emotions” (p=0.001), “Emotional warmth” (assessment of mothers and fathers, p=0.001) and “Encouraging independence” (assessment of mothers and fathers, p=0.001). Conclusion: JIA patients with chronic pain syndrome demonstrated more favorable mental health outcomes compared to patients with acne, which is traditionally considered as a factor in the mental adjustment disorder of adolescents that negatively affects the emotional state, self-esteem and the quality of life.