New McMaster research explores interplay of health and happiness in children with arthritis

Researchers at McMaster University are making strides to understand the mental health of children with juvenile idiopathic arthritis (JIA). This often painful and debilitating auto-immune condition affects one in every thousand children in Canada.

Research lead Michelle Batthish is an associate professor of pediatrics and a rheumatologist at McMaster Children’s Hospital in Hamilton. At the hospital’s clinic, doctors follow as many as 400 children with JIA annually. Batthish explains that children with chronic conditions like JIA face a heightened risk of mental health issues, including anxiety and depression.

“We know there’s an increased prevalence of mental health concerns,” says Batthish. “Now we’re asking, how bad is the problem, and how does it fluctuate with their disease course?”

With a new $240,000 grant from the Brain Canada Foundation, Batthish and her colleagues from the University of Waterloo will study how the mental health of children with JIA evolves over time in relation to their disease experience. The research aims to understand the interplay between physical illness and mental well-being.

“For someone struggling with mental health, their perceptions of pain may be heightened, leading to more frequent medical visits for therapy and other support,” remarks Batthish. “On the flip side, a flare-up in JIA can negatively impact a child’s mental health because now they’re missing that final baseball game or important school field trip.”

Children with JIA face challenges that surpass typical adolescent experiences, ranging from daily worries and anxiety to severe cases of self-harm and suicidal behaviour. Batthish has witnessed this full spectrum of mental health issues in her practice.

The upcoming study will recruit children aged two to 16 diagnosed with JIA from McMaster Children’s Hospital and Alberta Children’s Hospital. Participants will complete online surveys at multiple intervals to assess their mental health using the Ontario Child Health Survey—Emotional Behavioural Scales (OCHS-EBS) and the Mini International Neuropsychiatric Interview (MINI-KID), a gold-standard tool in psychiatric assessment.

Researchers will analyze data on disease activity, disability, parent mental health, and family resources to chart mental health trajectories and evaluate the accuracy of the OCHS-EBS. Additionally, selected caregiver-child pairs will be interviewed to capture the richness of their experiences, shedding light on how mental health changes are perceived and understood within families.

This study aims to deliver valuable insights into the mental health challenges faced by children with JIA. The findings could lead to early identification and targeted treatment, significantly improving the quality of life for these young patients. Furthermore, if the OCHS-EBS proves to be a reliable measure, it could become a standard tool for doctors worldwide, aiding in the regular monitoring of mental health in children with JIA.

Batthish emphasizes the potential impact of a validated tool to assess children’s mental health in her practice. “If patients can complete a quick questionnaire, we can use that as a guide to see if their condition is improving or getting worse,” she says. “We can determine whether to involve additional support such as social workers or adolescent medicine specialists.”

As this research unfolds, it holds the potential to revolutionize the support systems and mental health services available to children managing chronic conditions, offering them and their families hope and a brighter, healthier future.