Research has begun into looking at whether psychological stress can lead to young people with arthritis suffering flare-ups.
The study, led by BRC-supported Dr John Ioannou, will hopefully lead to a better understanding of a theory held by some doctors that when young people with juvenile idiopathic arthritis (JIA) suffer stress it can cause their condition to suddenly worsen.
Patients between 13-18 will complete a questionnaire which assesses their mood, well-being, anxiety and depression levels when they attend appointments at the Arthritis Research UK Centre for Adolescent Rheumatology, a collaboration between UCL, University College Hospital and Great Ormond Street Hospital which seeks to understand why rheumatic diseases can be more severe in teenagers.
The patients will also be asked if they have noticed that stress is a trigger for flare-ups and how they manage with this.
There will be a matching questionnaire pack for parents to find out about their child’s mood recently and if they are experiencing any stress as a parent.
During the first phase of the trial, 122 people have been recruited and 77 blood samples have been taken. The samples are studied in a laboratory to look at how the immune system changes in response to stress. The team plan to speak to the young people on a six-monthly basis to monitor their overall well-being and inflammatory markers.
PhD student Laura Hanns, a member of the study team, said: “We look at the questionnaire sections on mood and stressful life events and map that with their clinical symptoms. We also look at swollen joints and pain scores. We can see the C-reactive protein and erythrocyte sedimentation rate levels from the blood tests. From the blood sample I'll be looking for inflammatory markers and cytokine levels and if it looks like there's an elevation of these inflammatory markers that would support what patients tell us. This has never been looked at in patients with JIA or during adolescence before”.
The team anticipate this research will ultimately lead to new strategies that may revolve around psychological support that can help young people with JIA.
Clinical psychologist Dr Deborah Christie, who is also working on the project, said: "Support from a paediatric health psychology service can teach a number of stress management techniques as well as helping young people find ways to answer back to low mood or frustration."
JIA is the inflammation of one or more joints that occurs before the age of 16. There are several different types of JIA, some of which are milder than others.
