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Berthold E, Dahlberg A, Jöud A, Tydén H, Månsson B, Kahn F, Kahn R. Correction: The risk of depression and anxiety is not increased in individuals with juvenile idiopathic arthritis - results from the south-Swedish juvenile idiopathic arthritis cohort. Pediatr Rheumatol Online J 2024; 22:62. [PMID: 38886800 PMCID: PMC11184798 DOI: 10.1186/s12969-024-00995-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024] Open
Affiliation(s)
- Elisabet Berthold
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden.
- Skåne University Hospital, Lund and Malmö, Sweden.
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden.
| | - Alma Dahlberg
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Clinical Sciences Lund, Pediatrics, Lund University, Lund, Sweden
- Helsingborg Hospital, Helsingborg, Sweden
| | - Anna Jöud
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Department of Research and Education, Skåne University Hospital, Lund, Sweden
| | - Helena Tydén
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden
- Skåne University Hospital, Lund and Malmö, Sweden
| | - Bengt Månsson
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden
- Skåne University Hospital, Lund and Malmö, Sweden
| | - Fredrik Kahn
- Skåne University Hospital, Lund and Malmö, Sweden
- Department of Clinical Sciences Lund, Section of Infection Medicine, Lund University, Lund, Sweden
| | - Robin Kahn
- Skåne University Hospital, Lund and Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Clinical Sciences Lund, Pediatrics, Lund University, Lund, Sweden
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Milatz F, Klotsche J, Niewerth M, Sengler C, Windschall D, Kallinich T, Dressler F, Trauzeddel R, Holl RW, Foeldvari I, Brück N, Temming S, Hospach T, Warschburger P, Berendes R, Erbis G, Kuemmerle-Deschner JB, Weller-Heinemann F, Haas JP, Müller-Stierlin AS, Mutter A, Meissner T, Baumeister H, Minden K. Anxiety and depression symptoms in adolescents and young adults with juvenile idiopathic arthritis: results of an outpatient screening. Arthritis Res Ther 2024; 26:82. [PMID: 38600543 PMCID: PMC11005270 DOI: 10.1186/s13075-024-03312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Previous studies have shown that growing up with rheumatic conditions can fuel dissatisfaction and psychological distress, which in turn affects disease self-management and treatment adherence. Primary objective of this study was to estimate the prevalence of anxiety and depression symptoms in adolescents and young adults (AYA) with juvenile idiopathic arthritis (JIA) and to identify correlates of conspicuous screening results. METHODS Initiated as part of the COACH multicenter observational study, outpatients aged 12 to 21 years participating in the National Pediatric Rheumatological Database (NPRD) were prospectively screened for mental health using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder Scale-7 (GAD-7). RESULTS Data from 1,150 adolescents with JIA (mean age 15.6 ± 2.2 years; mean disease duration 7.2 ± 4.9 years, 69% female, 43% oligoarthritis, 26% polyarthritis) were analysed. Overall, 32.7% (n = 316) of AYA showed conspicuous screening results, of whom 30.4% reported clinically relevant suicidal or self-harm thoughts. About 19% of screened patients showed moderate to severe depressive or anxious symptoms. AYA with conspicuous screening results were older (15.8 vs. 15.2 years; p < 0.0001), more often female (81% vs. 64%; p < 0.0001) and more often overweight (25% vs. 17%; p = 0.006). They had higher disease activity (physician global assessment on NRS 0-10; 1.7 vs. 1.2; p < 0.0001), more functional limitations (CHAQ; 0.44 vs. 0.14; <0.0001) and rated their health status worse (NRS 0-10; 3.5 vs. 1.8; p < 0.0001) than AYA with inconspicuous screening results. Females (OR 2.33 [CI 1.53-3.56]; p < 0.0001), older age (OR 1.09 [CI 1.01-1.18]; p = 0.026), patients with more functional limitations (OR 3.36 [CI 1.98-5.72]; p < 0.0001), and patients with worse subjective health status (OR 1.17 [CI 1.07-1.27]; p < 0.0001) were more likely to have a conspicuous screening result. Regular sports participation was associated with a lower likelihood of conspicuous screening result (OR 0.69 [CI 0.49-0.98]; p = 0.039). CONCLUSIONS A large-scale outpatient screening of AYA with JIA in Germany shows a high prevalence of anxiety and depression symptoms. The need for routine screening for early detection of mental health problems became apparent.
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Affiliation(s)
- Florian Milatz
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany.
| | - Jens Klotsche
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
| | - Martina Niewerth
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
| | - Claudia Sengler
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Windschall
- Clinic of Paediatric and Adolescent Rheumatology, Northwest German Centre for Rheumatology, St. Josef- Stift Sendenhorst, Sendenhorst, Germany
- Medizinische Fakultät, Universität Halle-Wittenberg, Halle, Germany
| | - Tilmann Kallinich
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
- Programme area Systems Rheumatology, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Frank Dressler
- Department of Paediatric Pneumology, Allergology and Neonatology, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Ralf Trauzeddel
- Department of Paediatrics, Paediatric and Adolescent Rheumatology, Helios Klinik Berlin-Buch, Berlin, Germany
| | - Reinhard W Holl
- Institute for Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Centre for Diabetes Research (DZD), Munich, Germany
| | - Ivan Foeldvari
- Hamburg Centre for Paediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - Normi Brück
- Department of Paediatrics, Carl Gustav Carus, University Hospital, Technical University Dresden, Dresden, Germany
| | - Svenja Temming
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Toni Hospach
- Department of Paediatrics, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany
| | | | - Rainer Berendes
- Pediatric Rheumatology, Children's Hospital St. Marien, Landshut, Germany
| | - Gabriele Erbis
- Division of Pediatric Rheumatology and autoinflammation reference centre Tuebingen (arcT), Department of Pediatrics, University Hospital Tuebingen, member of ERN-RITA, Tuebingen, Germany
| | - Jasmin B Kuemmerle-Deschner
- Division of Pediatric Rheumatology and autoinflammation reference centre Tuebingen (arcT), Department of Pediatrics, University Hospital Tuebingen, member of ERN-RITA, Tuebingen, Germany
| | - Frank Weller-Heinemann
- Department of Pediatrics and Adolescent Medicine, Pediatric Rheumatology, Eltern-Kind-Zentrum Prof. Hess, Klinikum Bremen-Mitte, Bremen, Germany
| | - Johannes-Peter Haas
- German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | | | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - Thomas Meissner
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - Kirsten Minden
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
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Pedersen MJ, Høst C, Hansen SN, Deleuran BW, Bech BH. Psychiatric Morbidity Is Common Among Children With Juvenile Idiopathic Arthritis: A National Matched Cohort Study. J Rheumatol 2024; 51:181-188. [PMID: 37321635 DOI: 10.3899/jrheum.2023-0084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease that causes joint inflammation and pain. Previous studies have indicated affected mental health and increased risk of psychiatric conditions among patients with JIA. We aimed to explore differences in psychiatric morbidity between children with JIA and their peers. We further studied if parental socioeconomic status (SES) influences the association between JIA and the risk of psychiatric morbidity. METHODS We used a matched cohort design to estimate the association between JIA and psychiatric disease. Children with JIA, born between 1995 and 2014, were identified in Danish national registers. Based on birth registers, we randomly selected 100 age- and sex-matched children per index child. Index date was the date of the fifth JIA diagnosis code or the date of matching for reference children. End of follow-up was the date of psychiatric diagnosis, death, emigration, or December 31, 2018, whatever came first. Data were analyzed using a Cox proportional hazard model. RESULTS We identified 2086 children with JIA with a mean age at diagnosis of 8.1 years. Children with JIA had a 17% higher instantaneous risk of a psychiatric diagnosis when compared with the reference group, with an adjusted hazard ratio of 1.17 (95% CI 1.02-1.34). Relevant associations were found only for depression and adjustment disorders. Stratifying our analysis for SES showed no modifying effect of SES. CONCLUSION Children with JIA had a higher risk of psychiatric diagnoses compared to their peers, especially diagnoses of depression and adjustment disorders. The association between JIA and psychiatric disease did not depend on parental SES.
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Affiliation(s)
- Malthe Jessen Pedersen
- M.J. Pedersen, MD, S.N. Hansen, PhD, B.H. Bech, MD, PhD, Department of Public Health, Aarhus University;
| | - Christian Høst
- C. Høst, MD, PhD, Department of Paediatric and Adolescent Medicine, Aarhus University Hospital
| | - Stefan Nygaard Hansen
- M.J. Pedersen, MD, S.N. Hansen, PhD, B.H. Bech, MD, PhD, Department of Public Health, Aarhus University
| | - Bent Winding Deleuran
- B.W. Deleuran, MD, DMSc, Department of Rheumatology, Aarhus University Hospital, and Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bodil Hammer Bech
- M.J. Pedersen, MD, S.N. Hansen, PhD, B.H. Bech, MD, PhD, Department of Public Health, Aarhus University
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Milatz F, Albrecht K, Minden K, Marschall U, Klotsche J, Callhoff J. Mental comorbidities in adolescents and young adults with juvenile idiopathic arthritis: an analysis of German nationwide health insurance data. Pediatr Rheumatol Online J 2024; 22:10. [PMID: 38183044 PMCID: PMC10768083 DOI: 10.1186/s12969-023-00948-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Studies on prevalence rates of mental comorbidities in patients with juvenile idiopathic arthritis (JIA) have reported varying results and provided limited information on related drugs. The purpose of this study was to determine the prevalence of selected mental health diagnoses and the range of associated drug prescriptions among adolescents and young adults (AYA) with JIA compared with general population controls. FINDINGS Nationwide statutory health insurance data of the years 2020 and 2021 were used. Individuals aged 12 to 20 years with an ICD-10-GM diagnosis of JIA in ≥ 2quarters, treated with disease-modifying antirheumatic drugs and/or glucocorticoids were included. The frequency of selected mental health diagnoses (depression, anxiety, emotional and adjustment disorders) was determined and compared with age- and sex-matched controls. Antirheumatic, psychopharmacologic, psychiatric, and psychotherapeutic therapies were identified by Anatomical Therapeutic Chemical (ATC) codes and specialty numbers. Based on data from 628 AYA with JIA and 6270 controls, 15.3% vs. 8.2% had a diagnosed mental health condition, with 68% vs. 65% receiving related drugs and/or psychotherapy. In both groups, depression diagnosis became more common in older teenagers, whereas emotional disorders declined. Females with and without JIA were more likely to have a mental health diagnosis than males. Among AYA with any psychiatric diagnosis, 5.2% (JIA) vs. 7.0% (controls) received psycholeptics, and 25% vs. 27.3% psychoanaleptics. CONCLUSIONS Selected mental health conditions among 12-20-year-old JIA patients are diagnosed more frequently compared to general population. They tend to occur more frequently among females and later in childhood. They are treated similarly among AYA regardless of the presence of JIA.
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Affiliation(s)
- Florian Milatz
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum, a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany.
| | - Katinka Albrecht
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum, a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Kirsten Minden
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum, a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ursula Marschall
- Department Medicine and Health Services Research, BARMER Institute for Health System Research, Wuppertal, Germany
| | - Jens Klotsche
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum, a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, all Germany, Berlin, Germany
| | - Johanna Callhoff
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum, a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, all Germany, Berlin, Germany
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