Psychiatry Research EG

Introduction: Children with chronic illness have increased rates of mental health problems and psychological difficulties. Juvenile rheumatoid arthritis (JRA) is one of the most common rheumatic diseases of children and is considered a major cause of chronic disability in children. Thirty-eight percent of patients with JRA showed some difficulties in mental flexibility. Aim of this study: To detect psychiatric morbidity and cognitive deficit in a sample of children and adolescents with JRA, and to attempt to correlate the psychiatric and cognitive findings with concurrent cerebral perfusion abnormalities using the cerebral single photon emission computed tomography neuroimaging technique. Method: Thirty children and adolescents with JRA included in this study were recruited from the Pediatric Allergy and Immunology Unit, Childrens Hospital, Ain Shams University. These patients were subjected to full physical and psychiatric clinical interview, along with thirty healthy children and adolescents as the control group with matched age and sex. Patients and control groups were assessed using General Health Questionnaire, Wechsler Intelligence Scale, Revised Behavioral Problem Checklist, Mini kid test, Benton Visual Retention Test, and single photon emission computed tomographic imaging. Results: Significant difference in cerebral perfusion was observed in patients compared with the control group. Behavioral and cognitive function showed significant difference in patients compared with the control group. Patients with depression showed significant perfusion differences compared with the control group, as well as the anxiety group. Therapy duration and dose showed significant difference in different brain areas. Conclusion: Patients with JRA experience psychiatric morbidity as well as behavioral and cognitive dysfunction. The patterns of cerebral perfusion deficit are similar to those seen in depression, anxiety, and cognitive disabilities of patients.