Packham J C, Hall M A, Pimm T J
Oxford Regional Paediatric Rheumatology Unit, Wexham Park Hospital, Slough SL2 4HL, UK.
Rheumatology (Oxford). 2002 Dec;41(12):1444-9. doi: 10.1093/rheumatology/41.12.1444.
To examine the predictive factors for anxiety, depression and pain in adults with juvenile idiopathic arthritis (JIA).
Two hundred and forty-six adults identified with long-standing JIA had an average disease duration of 28.3 yr. Candidate factors potentially predictive for pain, anxiety and depression were assessed by multiple regression analysis.
Of the patients, 31.6% were anxious, 5.2% were depressed, and 21.1% had previously suffered from depression. The percentage of the variance accounted for by other variables was 78.8 for anxiety variance and 54.5 for depression, but there was little influence from physical disease-related factors. Severe pain, measured on a visual analogue scale, occurred in 32.9% of patients, and 22.8% had poor perceived control over their pain. Function, coping strategies, pain self-efficacy, inflammation and previous depression could predict 39.6% of the variance in pain.
Comparing adults with children, disease activity and control over pain remain predictors of pain but become less important than disability and coping strategies.
研究青少年特发性关节炎（JIA）成年患者焦虑、抑郁和疼痛的预测因素。
246例确诊为长期患JIA的成年患者，平均病程28.3年。通过多元回归分析评估可能预测疼痛、焦虑和抑郁的候选因素。
患者中，31.6%焦虑，5.2%抑郁，21.1%既往有过抑郁。其他变量解释的焦虑变异百分比为78.8，抑郁为54.5，但身体疾病相关因素影响较小。采用视觉模拟量表测量，32.9%的患者有严重疼痛，22.8%的患者对疼痛的自我控制感较差。功能、应对策略、疼痛自我效能感、炎症和既往抑郁可预测疼痛变异的39.6%。
与儿童患者相比，疾病活动度和疼痛控制仍是疼痛的预测因素，但比残疾和应对策略的重要性降低。
