# Symptoms and correlates of depression and anxiety in children and adolescents with juvenile idiopathic arthritis

## TL;DR

This study found that anxiety and depression are common in children with juvenile arthritis, even when their disease is inactive.

## Contribution

The study identifies biologic therapy and disability as factors linked to depression and anxiety in JIA patients.

## Key findings

- 10.3% of JIA patients had clinically relevant depressive symptoms.
- 51.7% of JIA patients had clinically relevant anxiety symptoms, with separation anxiety being most common.
- Depression and anxiety symptoms were present even in patients with inactive disease.

## Abstract

Juvenile idiopathic arthritis (JIA) can impair physical functioning and increase psychological burden. This study aimed to examine factors associated with clinically relevant depression and anxiety symptoms, and to describe the prevalence of clinically relevant depression and anxiety symptoms in children and adolescents with JIA.

We conducted a prospective cross-sectional study from July 2020 to June 2022 among JIA patients aged 8‒17 years at the largest university-based tertiary hospital in Bangkok, Thailand. Clinically relevant depression and anxiety symptoms were measured using the Children’s Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders (SCARED).

Eighty-seven patients (50 males, 37 females) with a median age of 12.6 (IQR 9.8‒14.4) years were enrolled. The median disease duration was 38 (IQR 10‒67) months, and 61 (70.1%) exhibited clinically inactive disease. Nine (10.3%) had clinically relevant depressive symptoms, while 45 (51.7%) had clinically relevant anxiety symptoms. Among these 45, 34 (75.6%) exhibited separation anxiety, 16 (35.6%) social anxiety, 15 (33.3%) school anxiety, 6 (13.3%) panic symptoms, and 6 (13.3%) generalized anxiety. CDI scores were significantly correlated with SCARED scores (r = 0.519, P < 0.001). Multiple linear regression revealed that biologic therapy was associated with clinically relevant depressive symptoms (standard β = 0.353, 95%CI 3.064–13.286, P = 0.002), whereas disability was associated with clinically relevant anxiety symptoms (standard β = 0.325, 95%CI 0.998-10.153, P = 0.018).

Symptoms of depression and anxiety were common even in JIA patients with clinically inactive disease. Routine mental health screening should be integrated into clinical care.