Use of psychotropic medication in incident juvenile idiopathic arthritis patients from 2000 to 2014: a case-control cohort study.

OBJECTIVES: To explore the use of psychotropic medications in patients with juvenile idiopathic arthritis (JIA) compared to population controls. METHODS: Using register data from the Social Insurance Institution of Finland and the National Population Registry, we collected all incident JIA patients with index dates from 2000 to 2014 (n=4,180) and three population comparators for each case (n=12,512). For these individuals, we obtained information on their psychotropic medication from the registry on prescriptions, which includes all purchases of prescription medicines in pharmacies. The study populationwas followed from their index dates until 31 December 2015. The data were analysed using generalised linear models. RESULTS: The mean age (SD) of the JIA patients at disease onset was 8.3 (4.8) years, and 14.8 (6.4) years at the end of the follow-up period. During the follow-up years, 566 (13%) of the JIA patients had purchased some psychotropic drug from a pharmacy, whereas the number in the control group was 1,294 (10%; p<0.001). Antidepressants were the most purchased drugs in both groups. Further analysis by gender showed that females with JIA used antidepressants more often than males with JIA. CONCLUSIONS: The use of psychotropic medication, particularly antidepressants, was more common in patients with JIA compared to comparators in the general population. This reflects the presence of clinically important mental health problems in JIA patients and the need for multiprofessional collaboration in patient care.

Psychiatric disorders in incident patients with juvenile idiopathic arthritis - a case-control cohort study.

BACKGROUND: Chronic illness, such as juvenile idiopathic arthritis (JIA), appears to have an impact on the mental health of children and adolescents. The aim of this study was to explore the incidence of mental and behavioural disorders according to age at JIA onset and gender in JIA patients compared to a control population. METHODS: Information on all incident patients with JIA in 2000-2014 was collected from the nationwide register, maintained by the Social Insurance Institution of Finland. The National Population Registry identified three controls (similar regarding age, sex and residence) for each case. They were followed up together until 31st Dec. 2016. ICD-10 codes of their psychiatric diagnoses (F10-F98) were obtained from the Care Register of the National Institute for Health and Welfare. The data were analysed using generalized linear models. RESULTS: The cumulative incidence of psychiatric morbidity was higher among the JIA patients than the controls, hazard ratio 1.70 (95% Cl 1.57 to 1.74), p < 0.001. Phobic, anxiety, obsessive-compulsive, stress-related and somatoform disorders (F40-48) and mood (affective) disorders (F30-39) were the most common psychiatric diagnoses in both the JIA patients (10.4 and 8.2%) and the control group (5.4 and 5.1%), respectively. Female patients were more prone to mental and behavioural disorders than males were, and the risk seemed to be higher in patients who developed JIA in early childhood or adolescence. CONCLUSION: Patients with JIA are diagnosed with mental and behavioural disorders more often than controls, and the age at onset of JIA could have implications for future mental health.