273. In Adolescent Patients with Juvenile Idiopathic Arthritis, Anxiety and Mood Predicts Function Whereas Life Event Stressors in the Older Adolescent Predicts Inflammation

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Background: It is often reported by patients and clinicians that during times of stress patients with inflammatory arthritis experience flares of disease. This is particularly prevalent during adolescence, a time of high stress for many. There is increasing scientific evidence emerging that shows how stress, anxiety and depression can trigger changes to the immune system such as increased susceptibility to inflammation. Several studies have shown an association between psychological distress and worsened disease in RA in adults, yet this association has never been explored in detail for patients with JIA or in a purely adolescent population.

Methods: 106 patients with JIA between the ages of 13 and 18 years were recruited from University College Hospital, London, and gave informed consent [median age 17 (interquartile range 2)], 50% male). Each patient completed a questionnaire pack assessing chronic stress (Coddington Life Event Scale – Adolescent Version), anxiety (State–Trait Anxiety Inventory) and depression (Short Mood and Feelings Questionnaire – Child Version). Disease activity measures explored were the Childhood HAQ (CHAQ), ESR, CRP and swollen and limited joint counts. Data were analysed using the Spearman’s rank correlation coefficient and the Mann–Whitney U test.