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. 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). 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). 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.

中文翻译：

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患有幼年特发性关节炎的青少年和年轻人的焦虑和抑郁症状：门诊筛查结果

先前的研究表明，患有风湿病的成长过程会加剧不满和心理困扰，进而影响疾病的自我管理和治疗依从性。本研究的主要目的是估计患有幼年特发性关节炎（JIA）的青少年和年轻人（AYA）焦虑和抑郁症状的患病率，并确定显着筛查结果的相关性。作为 COACH 多中心观察性研究的一部分，使用患者健康问卷 9 (PHQ-9) 和广泛性焦虑症量表对参与国家儿科风湿病数据库 (NPRD) 的 12 至 21 岁门诊患者进行前瞻性心理健康筛查-7（GAD-7）。对 1,150 名 JIA 青少年（平均年龄 15.6 ± 2.2 岁；平均病程 7.2 ± 4.9 年，69% 女性，43% 少关节炎，26% 多关节炎）的数据进行了分析。总体而言，32.7%（n = 316）的 AYA 显示出显着的筛查结果，其中 30.4% 报告了临床相关的自杀或自残想法。约 19% 的筛查患者表现出中度至重度抑郁或焦虑症状。筛查结果显着的 AYA 年龄较大（15.8 岁 vs. 15.2 岁；p < 0.0001），女性更常见（81% vs. 64%；p < 0.0001），超重的情况更常见（25% vs. 17%；p = 0.006） 。他们的疾病活动度较高（医生对 NRS 0-10 的总体评估；1.7 与 1.2；p < 0.0001），功能受限较多（CHAQ；0.44 与 0.14；<0.0001），并且认为自己的健康状况较差（NRS 0-10） ; 3.5 vs. 1.8; p < 0.0001) 比 AYA 低，筛查结果不明显。女性（OR 2.33 [CI 1.53–3.56]；p < 0.0001）、年龄较大（OR 1.09 [CI 1.01–1.18]；p = 0.026）、功能受限较多的患者（OR 3.36 [CI 1.98–5.72]；p < 0.0001），主观健康状况较差的患者（OR 1.17 [CI 1.07–1.27]；p < 0.0001）更有可能获得明显的筛查结果。定期参与体育运动与筛查结果显着的可能性较低相关（OR 0.69 [CI 0.49–0.98]；p = 0.039）。德国对患有 JIA 的 AYA 进行的大规模门诊筛查显示，焦虑和抑郁症状的患病率很高。进行常规筛查以及早发现心理健康问题的必要性变得显而易见。