Psychosocial factors related to rheumatic diseases in childhood.

This review discusses those features of psychosocial adjustment which have been found associated with rheumatic diseases in children. In spite of the older literature and widely held intuitive beliefs, children with those diseases tend to do well in both psychological and social development and function. Those who do least well have risk factors which are those which impinge on the adjustments of any healthy child. Those who do best are those who have a strong social support system, particularly maternal competence. Children may cope in part by positive use of denial. Thus, interventions should be tailored to just those children and families at risk and must take into account the individual child's method of coping. It is argued that generalized interventions and education are unnecessary and may be harmful.