169: Catastrophizing and depressive symptoms predict PROs in Juvenile Idiopathic Arthritis (JIA)

Topic: Clinical Science
Subtopic:

Background and Aims: Juvenile Idiopathic Arthritis (JIA) affects daily functioning and quality of life. Beyond inflammation, psycho-emotional factors may influence how children and parents perceive disease status and patient-reported outcomes (PROs).This study aimed To evaluate the contribution of children’s and parents’ psychological variables to perceived disease impact and well-being in JIA, comparing child- and parent-reported outcomes.

Methods: One hundred thirty patients with JIA (96 females, 34 males; 6–17 years) and one parent each were recruited. Parents completed orofacial assessment questionnaires, the parent version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR), and the Pain Catastrophizing Scale for Parents (PCS-P). Children completed the Pain Catastrophizing Scale for Children (PCS-C), Perceived Stress Scale for Children (PSS-C), anxiety and depression (RCADS-SV), and PROs on quality of life and disease status (JAMAR), jaw functional limitation (JFLS-8). All patients underwent temporomandibular disorder examination using DC/TMD criteria. Associations between PROs and psychological variables were tested, followed by multivariate models.

Results: Results: Children reported overall low disease burden and favorable JAMAR profiles. Parent perceptions were largely aligned, with no significant differences between child- and parent-completed JAMAR domains. Children’s JAMAR scores correlated with parental JAMAR ratings and with psychological measures from both informants. In multivariate analyses, children’s pain catastrophizing (PCS-C) emerged as the strongest psychological predictor across JAMAR domains (pain, functional disability, and perceived disease activity). Depressive symptoms showed independent associations with poorer quality of life and higher perceived disease impact.

Conclusions: In pediatric JIA, pain catastrophizing and depressive symptoms are key psycho-emotional correlates of PROs for both patients and parents. Incorporating routine screening for catastrophizing and mood symptoms—and offering targeted psychological interventions when indicated—may improve illness perception and overall well-being alongside standard rheumatologic care. Supporting a biopsychosocial care approach.

References: Bovis F, Consolaro A, Pistorio A, et al. Cross-cultural adaptation and psychometric evaluation of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) in 54 languages across 52 countries: review of the general methodology. Rheumatol Int. 2018;38:5-17. doi:10.1007/s00296-018-3944-1
Crombez G, Bijttebier P, Eccleston C, et al. The child version of the pain catastrophizing scale (PCS-C): A preliminary validation. Pain. 2003;104(3):639-646. doi:10.1016/S0304-3959(03)00121-0
Goubert L, Eccleston C, Vervoort T, Jordan A, Crombez G. Parental catastrophizing about their child’s pain. The parent version of the Pain Catastrophizing Scale (PCS-P): A preliminary validation. Pain. 2006;123(3):254-263. doi:10.1016/j.pain.2006.02.035
White BP. The Perceived Stress Scale for Children: A Pilot Study in a Sample of 153 Children . Int J Pediatr Child Health. 2014;2(2):45-52. doi:10.12974/2311-8687.2014.02.02.4
Ebesutani C, Reise SP, Chorpita BF, et al. The Revised Child Anxiety and Depression Scale-Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor. Psychol Assess. 2012;24(4):833-845. doi:10.1037/a0027283
Ohrbach R, Larsson P, List T. The Jaw Functional Limitation Scale: Development, Reliability, and Validity of 8-Item and 20-Item Versions.; 2008. https://www.researchgate.net/publication/23246309
Rongo R, Ekberg EC, Nilsson IM, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: An international Delphi study—Part 1-Development of Axis I. J Oral Rehabil. 2021;48(7):836-845. doi:10.1111/joor.13175
Rongo R, Michelotti A, Bucci R, Vitale F, Stoustrup P, Valletta R. Evaluation of psychosocial aspects in patients with juvenile idiopathic arthritis. Semin Orthod

Presenting Author: Roberto Rongo
Submitting Author: Roberto Rongo

Senior Author: Ambrosina Michelotti

IASP 2026 Global Year theme of Neuropathic Pain: No

• Rosaria Bucci - University of Naples Federico II
• Roberta Naddei - University of Naples Federico II
• Alessia Polverino - University of Naples Federico II
• Ambrosina Michelotti - University of Naples Federico II