A. Aasland et al., PSYCHOSOCIAL OUTCOME IN JUVENILE CHRONIC ARTHRITIS - A 9-YEAR FOLLOW-UP, Clinical and experimental rheumatology, 15(5), 1997, pp. 561-568
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.