Health-related quality of life and emotional problems in juvenile idiopathic arthritis

Children with juvenile idiopathic arthritis (JIA) are at an increased risk of developing emotional problems. This study evaluated
the associations between levels of depressive and anxiety symptoms and health-related quality of life (HRQOL) in these children.

Sixty-seven children with JIA, together with one parent, participated. Anxiety symptoms were identified using the Screen for
Child Anxiety Related Emotional Disorders Questionnaire (SCARED), while depressive symptoms were identified using the Mood
and Feeling Questionnaire (MFQ). The Pediatric Quality of Life Inventory (PedsQL) was used for HRQOL assessments. Using hierarchical
multiple-regression analysis, demographics, clinical factors, and pain were control variables, while anxiety (the SCARED score)
and depressive symptoms (the MFQ score) were HRQOL (the PedsQL score) predictors.

The regression model emerged with specified variables explaining 63 % of the variance in the PedsQL score (F = 11.92, p < 0.01) among children. Among parents, the same set of variables accounted for 49 % the variance (F = 6.99, p < 0.01). The MFQ score, but not the SCARED, added most to the variance.

Depressive symptoms, but not anxiety, accounted for substantial variability in levels of HRQOL when considered with demographics,
clinical factors, and pain. Thus, screening for depression needs to be considered as a part of multimodal assessment and treatment
approaches in JIA.