AB0976 PSYCHIATRIC DISORDERSDURING TRANSITION CARE IN ADOLESCENTS WITH RHEUMATIC DISEASES
Authors: FERNANDO GARCíA-RODRIGUEZ, Lucero Ochoa-Alderete, Antonio López-Rangel, Daniela Padilla, Ana Villarreal-Trevino, María Eugenia Corral Trujillo, Ana Cecilia Arana Guajardo, Roberto Negrete, Brenda Fortuna, Manuel E. De la O-Cavazos, Dionicio ángel Galarza-Delgado, Nadina Rubio
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Chronic rheumatic diseases (CRD) have a strong impact on psychosocial development of pediatric patients. There are several factors associated with psychiatric disorders (PD) in these children; physical disability, complex treatments, long-term follow-up, and flares, are the most cited in literature. Juvenile Idiopathic Arthritis (JIA) is the first cause of disability in children with CRD, on the other hand, Major Depressive Disorder (MDD) and Dysthymia are the third cause. Some PD, mostly MDD, appear as a consequence of disability caused by CRD, but immune pathways might be implicated in pathogenesis as well. Adolescents with CRD need to transition to an adult-centered care while deal with emotional and physical changes. This implies a difficult situation in which patients could be in higher risk for develop PD. There are a lack of information on how this process affects emotional health in this population. <h3>Objectives</h3> The aim of the study is to calculate the prevalence of PD in adolescents with CRD during transitional care and their relationship with clinical and social factors. <h3>Methods</h3> Patients older than 16 years with an established CRD, who were in transitional care during the period between July 2017 and January 2019 were included in this transversal study. We used MINI KID assessment tool to characterize PD in our patients. Each patient performs an interview with both a clinical psychologist and a pediatric psychiatrist to confirm psychiatric/emotional diagnosis. Clinical, social and demographic data were collected from medical records. Descriptive statistics with frequencies or measures of central tendency and dispersion, depending on variable characteristics were used. Comparisons and correlations were performed with parametric and non-parametric tests as appropriate. <h3>Results</h3> Forty patients were recruited during study period, aged 18 (IQR 16 - 19) years old, 31 female, and most diagnosed with JIA (22, 55%) and Systemic Lupus Erythematosus (SLE, 7, 17.5%). Time since diagnosis were 5.5 (IQR 0.5 - 13) years and half of the patients presented with an active disease. After psychiatric evaluations, 24 (60%) patients presented a PD, 7 (17.5%) were identified with MDD, while minor disorders (specific phobia and anxiety) were notice in 11 (27.5%). Two patients presented alcohol dependence, and 11 (27.5%) were diagnosed with more than one PD. PD were more frequently in patients with SLE (71%) and in those with active disease regardless underlying diagnosis (54% vs 45%, P = .490). Other significant factors related with more prevalence of PD were female gender (66% vs 44%, P &lt; .001), having a couple (90% vs 57%, P &lt; .001), have a single parent (83% vs 60%, P = .005), and sex activity (71% vs 61%, P = .002). <h3>Conclusion</h3> We found a higher prevalence of PD in adolescents during transitional care, especially in those with active disease. It is priority to involve a multidisciplinary team to transition adolescents from pediatric to adulthood care to prevent and detect PD in this population. <h3>References</h3> [1] Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007;369(9563):767–78. [2] Vos, Theo, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for. Lancet. 2017;390. [3] Nerurkar L, Siebert S, McInnes IB, Cavanagh J. Rheumatoid arthritis and depression: an inflammatory perspective. The Lancet Psychiatry. 2018; <h3>Disclosure of Interests</h3> None declared