Increased Burden of Psychiatric Morbidity in Patients With Juvenile Idiopathic Arthritis

Incidence and burden of psychiatric disorders are increased among patients with juvenile idiopathic arthritis (JIA), which may be related to environmental stressors and genetic susceptibility, according to study findings published in ACR Open Rheumatology.

Researchers evaluated the incidence of psychiatric outcomes in individuals with JIA compared with matched individuals from the general population and with same-sex siblings without JIA.

Prospective data were collected in Sweden from July 2006 through December 2020. Three cohorts were included in the analysis: patients with incident JIA vs age- and sex-matched individuals from the general population; patients with incident JIA vs same-sex siblings; and patients with prevalent JIA vs the general population (cross-sectional analysis).

A total of 4939 individuals and 24,207 sex- and age- matched comparators were included in the study. The median age of individuals with incident JIA was 9.7 years, with 62% being girls.

Over a period of 25,141 person-years, 4939 patients with JIA were monitored. The incidence rate of the combined outcome was 20.1 per 1000 person-years among patients with JIA, which was higher than the rate of 13.1 per 1000 person-years in the general population. After adjusting for other factors, the hazard ratio (HR) was 1.49 (95% CI, 1.35-1.65), indicating a higher risk of the combined outcome in patients with JIA.

The 3 highest HRs were for sleep disorder (HR, 1.91; 1.41-2.59), suicidal behavior (HR, 1.60; 1.23-2.07), and mood and anxiety disorders (HR, 1.46;1.30-1.64). The HR for psychotic disorders was also increased; however, it was not statistically significant.

In the second cohort, 1815 patients with JIA were compared with 2050 of their siblings to evaluate the overall combined outcome. The results showed a nonstatistically significant association (HR, 1.16; 95% CI, 0.82-1.64).

The cross-sectional analysis indicated that patients with JIA aged 18 years and younger had a higher probability of being diagnosed with a psychiatric disorder (odds ratio [OR], 1.37; 95% CI, 1.25-1.50).

The study was limited by whether surveillance bias affected patients with JIA or the entire family.

Researchers concluded, “[P]atients with JIA are at increased risk of developing psychiatric disorders, resulting in an increased burden of psychiatric comorbidities, both in childhood and when reaching adulthood.”