Good disease control , with therapeutic escalation to achieve low disease activity , was recommended .
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis , sacroiliitis , or enthesitis .
Pain, stiffness, and fatigue in juvenile polyarticular arthritis: contemporaneous stressful events and mood as predictors.
OBJECTIVE To analyze patterns of stress , mood , disease symptoms , and activity reduction in children with polyarticular arthritis , using a prospect i ve daily diary method . METHODS For a 2-month period , 51 children with polyarticular arthritis ( mean age 12.4 years , 65 % female ) completed daily diaries that included measures of symptoms of pain , stiffness , and fatigue , as well as stress , mood , and activity reduction . Functional status and disease activity were assessed at the initial and followup evaluations with use of the Childhood Health Assessment Question naire , physician global assessment , joint count , and laboratory testing . RESULTS Children reported having pain , stiffness , and fatigue on > 70 % of days , with significant variability in symptom levels . Results revealed significant same-day relationships between stress , mood , and disease symptoms , after controlling for covariates . Specifically , daily fluctuations in both stress and mood were predictive of increased pain , stiffness , and fatigue . Increases in daily stress , mood , and disease symptoms were also significantly related to decreased participation in social activities on a day-to-day basis . Only mood and stiffness were predictors of a cutback in school attendance . CONCLUSION Stress and mood are important predictors of daily disease symptoms in children with polyarticular arthritis . Moreover , daily fluctuations in stress , mood , and disease symptoms are predictive of aspects of daily function , including participation in school and social activities . Thus , health care providers should solicit daily symptom reports when making decisions regarding clinical management . Nonpharmacologic interventions such as cognitive-behavioral therapy and stress management may be useful adjuvant therapy when treating the disease symptoms of children with polyarticular arthritis
Good disease control , with therapeutic escalation to achieve low disease activity , was recommended .
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis , sacroiliitis , or enthesitis .