What is the Impact of Adolescent Arthritis and Rheumatism?

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What is the Impact of Adolescent Arthritis and Rheumatism? Evidence from

a National Sample of Canadians

(J Rheumatol 2005;32:354-61)

http://www.jrheum.com/abstracts/abstracts05/354.html

VIVIANE ADAM, YVAN ST.-PIERRE, BRUNO FAUTREL, ANN E. CLARKE, CIARÁN M.

DUFFY, and JOHN R. PENROD

ABSTRACT.

Objective. Adolescent arthritis or rheumatism (AAR) has been shown to

influence the activities, mental health, and healthcare utilization of

affected individuals. However, these effects have never been estimated

in a population-based sample. We examined the association of AAR with

health status, health services use, health behaviors, and activity

limitations. We also investigated the effect of socioeconomic status and

family background on respondents with AAR.

Methods. The 1996 National Population Health Survey is a nationally

representative survey exploring the health status and behaviors of

Canadians. Among the 26,012 individuals aged 12 to 19 with complete

responses on the presence of chronic illnesses, the 213 self-reporting

arthritis or rheumatism (AAR) were compared to: (1) all other

adolescents as a single group; or (2) the group of 9161 adolescents

reporting other chronic diseases (OCD) but not AAR, and the group of

16,638 adolescents without chronic disease (WCD). Between-group

differences were examined for the following variables: health status;

use of health services; presence of activity limitations in school,

work, or at home; and school enrollment and work status.

Results. Compared to those without, respondents with AAR reported more

diagnoses of non-AAR chronic illnesses. Depression among AAR individuals

was more prevalent than among non-AAR individuals, as was suffering from

moderate or severe pain. Those with AAR were more likely than WCD

individuals to use physician services, hospital services, and pain

relief medications. AAR patients were more likely to be limited in their

activities, and less likely to be enrolled in school than OCD or WCD

individuals.

Conclusion. This study indicates a broad range of effects of AAR in a

nationally representative sample. Arthritis or rheumatism affected

measures of mental health, health service use, and the school, work, and

home activities of affected individuals, compared to individuals without

chronic disease or with other chronic disease.

From the Division of Clinical Epidemiology, McGill University Health

Centre, The Montreal General Hospital, Montreal, Canada; Division of

Rheumatology, Pitié-Salpêtrière Hospital, Paris, France; Division of

Clinical Immunology/Allergy, McGill University Health Centre, The

Montreal General Hospital; and Division of Pediatric Rheumatology,

McGill University Health Centre, Montreal Children's Hospital, Montreal,

Canada.

Dr. e is a Canadian Institutes of Health Research (CIHR)

Investigator. Dr. Duffy is a former Research Scholar of The Arthritis

Society and is currently recipient of the Sessenwein Award for Research,

Department of Paediatrics, McGill University. Supported by a research

grant from the Canadian Arthritis Network.

V. Adam, MSc; Y. St.-Pierre, MSc, Division of Clinical Epidemiology,

McGill University Health Centre; B. Fautrel, MD, Division of

Rheumatology, Pitié-Salpêtrière Hospital; A.E. e, MD, MSc, FRCPC,

Division of Clinical Epidemiology, and Division of Clinical

Immunology/Allergy, McGill University Health Centre; C.M. Duffy, MBBCh,

MSc, FRCPC, Division of Pediatric Rheumatology, McGill University Health

Centre, Montreal Children's Hospital; J.R. Penrod, PhD, Division of

Clinical Epidemiology, McGill University Health Centre.

Address reprint requests to J. Penrod, Division of Clinical

Epidemiology, The Montreal General Hospital, 1650 Cedar Avenue,

Montreal, Quebec H3G 1A4, Canada.