Psychosocial Factors May Be Associated With and Predictive of Pain Among Children With JIA

Psychosocial elements including pain perception, internalization of symptoms, and overall well-being are commonly associated with and may be able to forecast juvenile idiopathic arthritis (JIA) pain, according to results of a systematic review published in Pediatric Rheumatology.

Pain is a frequently reported symptom among children with JIA and can be influenced by a number of factors. However, data on the influence of psychosocial factors are lacking. To address this gap, researchers assessed which psychosocial factors are associated with and may be predictive of pain intensity, frequency, and sensitivity among children with JIA.

Children aged 17 years or younger with a diagnosis of JIA were included in the study. A systematic search yielded a total of 61 studies that met the inclusion criteria set by the study authors.

A total of 42 studies reported 183 associations between pain and outcomes such as mental health, pain interference, and well-being. Of these associations, 104 were found to be statistically significant.

There were no significant associations (0/8 associations) found between broad measures of child mental health and pain intensity. Additionally, no associations were found between pain intensity and externalizing symptoms, such as behavioral issues.

Positive associations were observed between internalizing symptoms (such as distress and emotional functioning) and pain intensity (10/16 associations). Additionally, a positive association was found between internalizing symptoms and pain frequency (1/1 association).

No correlation was found between lower pain intensity and child/parent-reported emotion regulation or adaptive upregulation of positive emotions. However, findings suggested children with lower pain intensity demonstrated improved ability to manage negative emotions and exhibited fewer day-to-day mood fluctuations, specifically by showing reduced variability in both positive and negative effects.

Study findings indicated that lower pain intensity (28/37 associations) and lower pain intensity variability (1/1 association) were significantly associated with greater health-related quality of life. Additionally, lower pain intensity (15/16 associations) and pain frequency (4/4 associations) were significantly associated with greater well-being.

The scope of this systematic review was limited by the exclusion of patients aged 18 years or older. Researchers noted that certain studies were possibly overlooked if they did not specifically mention pain or employed alternative pain dimension measures within their abstracts.

“These findings have important clinical implications. Of primary importance is that pain should be assessed comprehensively and regularly at clinics,” the study authors stated.

“The psychosocial factors identified play an important role in the child’s pain experience, regardless of whether they cause, are caused by, or are only tangentially related to JIA pain,” they concluded.

This article originally appeared on Rheumatology Advisor