Empirical classification of children with JIA: a multidimensional approach to pain and well-being

CER3449
2008 Vol.26, N°5
PI 0954, PF 0961
Paediatric Rheumatology

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PMID: 19032837 [PubMed]

Abstract

OBJECTIVES:
To investigate the relationship between children`s arthritis self-efficacy, trait-anxiety, depression, clinical state of the disease (pain, disability, number of somatic complaints and active joints) and age of the child.
METHODS:
Trait anxiety and depression of JIA patients were measured by standardized scales (STAIC and CDI). For assessing self-efficacy CASE-scale was used. Pain, CHAQ and active joint count were used as indicators of the disease severity. The K-means cluster procedure was used to classify 145 consecutively recruited patients aged 8 to 15, regarding age, trait-anxiety and depression. One-way multivariate analysis of variance (MANOVA) followed by separate ANOVA`s was used for comparisons between the cluster groups. Associations between the cluster groups and the children`s self-efficacy were then evaluated using multivariate analysis of variance (MANOVA).
RESULTS:
Four cluster groups were identified based on the degree of depression and trait-anxiety. Clinical disease-related parameters differed significantly in the cluster groups. Pain was not necessarily related to the severity of the disease or to the diagnosis (oligoarthritis, oligoextended and polyarthritis). A higher level of self-efficacy was related to lower levels of depression, trait anxiety and pain.
CONCLUSIONS:
In JIA, the clinical classification of disease activity and severity did not directly correspond with depression and trait-anxiety in children with JIA. Instead, these were regulated by a self-efficacy, which was associated with less pain and somatic complaints.