High Rates of Symptoms of Major Depressive Disorder and Panic Disorder in a Canadian Sample of Adolescents With Juvenile Idiopathic Arthritis

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The Journal of rheumatology


OBJECTIVE: We aimed to evaluate the rate of depressive and/or anxiety symptoms in adolescents with JIA and explore the association with demographic and disease activity measures.

METHODS: Depressive and anxiety symptoms were assessed in adolescents with JIA aged 12-18 at a Canadian tertiary-care hospital, using the Revised Child Anxiety and Depression Scale (RCADS). The RCADS includes 6 subscales: Separation Anxiety, Social Phobia, Generalized Anxiety, Panic Disorder, Obsessive Compulsive, and Major Depressive Disorder. Scores above "clinical threshold" on the RCADS subscales indicate that an individual's responses reflect symptoms similar to those diagnosed with the corresponding mental health disorder. Fisher's exact test and Mann-Whitney U test were used to compare demographic and disease-related between participants who scored above and below clinical threshold on each of the subscales.

RESULTS: 32/80 (40%) of participants scored above clinical threshold on at least one subscale. Scores above clinical threshold were most frequent for Major Depressive Disorder (23.8%) and Panic Disorder (22.5%) subscales. Social Phobia and Separation Anxiety followed with 16.3% and 13.8% respectively. Females were more likely to have scores above clinical threshold on the Panic Disorder subscale. Participants with higher self-reported disease activity were more likely to have scores above clinical threshold for all anxiety subscales except Separation Anxiety.

CONCLUSION: We report high rates of symptoms of depression and anxiety (panic in particular) in adolescents with JIA. This highlights the ongoing need for mental health screening protocols and services. The relationships between concomitant mental health disorders, disease activity and patient-reported outcomes requires further research.

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ePub ahead of print