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Adolescent patients reported mixed beliefs behind causes of JIA
Adolescents had varied beliefs about the underlying cause of their juvenile arthritis, with genetics and the immune system being the most common, according to study results.
“The most important thing we learned was that beliefs about the cause of arthritis among these young people were varied, related to symptoms at presentation as well as the route of referral,” researcher Kimme Hyrich, MD, PhD, FRCPC, honorary consultant in rheumatology at the University of Manchester, told Healio.com.
Kimme Hyrich
Researchers in the United Kingdom studied 122 adolescents (median age, 13.3 years; 58.2% female; 86.1% Caucasian) who were part of a larger study of more than 1,300 children presenting with new onset arthritis. One hundred sixteen patients (95%) had juvenile idiopathic arthritis (JIA). Patients completed a questionnaire regarding underlying beliefs about their arthritis. Associations between adolescents’ beliefs and their characteristics were compared.
Genetics (27.1%), the immune system (21.3%), accident or injury (15.6%), infection (13.1%), chance or bad luck (9%), environment and well-being (8.2%), and psychological (3.3%) were the adolescents’ causal beliefs. None attributed their JIA to smoking or alcohol, although some might have indulged in those activities, researchers reported.
Small numbers of the perceived causes prevented robust statistical comparisons. Age was not associated with variations in causal beliefs. Genetics or the immune system were more likely to be listed as causes by females, compared with accident or injury that were reported by males. Patients who were referred from orthopedists were more likely to perceive accident or injury as cause.
Among JIA subtypes, adolescents with systemic arthritis listed infection or genetics/immune system as causes, while accident or injury was most commonly listed among patients with persistent oligoarthritis.
“Illness beliefs have been found to correlate with longer term outcomes of disease as well as adherence to treatments,” Hyrich said. “So understanding patient beliefs and sharing information with our patients about what we do know about arthritis is important.
“It was very interesting to undertake our research directly with the young people [as opposed to proxy reporting through parents].”