PSYCHOSOCIAL OUTCOME IN JUVENILE CHRONIC ARTHRITIS - A 9-YEAR FOLLOW-UP

Objective. To describe the long-term psychosocial outcome in a prospec tively followed cohort of patients with juvenile chronic arthritis (JC A), to assess the associations between psychosocial outcome and diseas e variables and to explore family stressors as predictors of long-term psychosocial and physical outcome. Methods. Fifty-two patients with J CA were assessed psychosocially at first admission to a pediatric rheu matology clinic and were reassessed 9 years later Assessment methods i ncluded semi-structured psychiatric interviews and standardized parent al questionnaires and self-reports. Results. At follow-up, 9 patients (17%) fulfilled the criteria for a psychiatric diagnosis and 8 (15%) h ad mild to moderate impairment in psychosocial functioning (children's or adult Global Assessment Scale). Mental health and psychosocial fun ctioning were significantly improved from the first hospital admission to follow-up. In patients < 18 years of age (n = 26), psychosocial fu nctioning at follow-up correlated with physical disability according t o the Childhood Health Assessment Questionnaire (r = -0.52, p < 0.01). Psychosocial outcome was unrelated to other measures of disease sever ity Chronic family difficulties in the disease course predicted psycho social functioning at follow-up in patients < 18 years old (R-2 = 0.22 ). Chronic family difficulties at disease onset, together with gender and chronic family difficulties in the disease course, predicted psych osocial functioning at follow-up in patients greater than or equal to 18 years old (R-2 = 0.61). Family stressors were unrelated to the phys ical outcome. Conclusion. The long-term psychosocial outcome was favor able in most of the patients, Psychosocial outcome was predicted by ch ronic family difficulties, but was not closely related to disease seve rity at follow-up.