Scientists studying children with juvenile arthritis have found that increased pain and fatigue are linked to reduced participation in school and social activity. In addition, the researchers, led by Laura E. Schanberg, M.D., of Duke University Medical Center, noted that anxiety is also significantly associated with increased pain and fatigue.

Physicians, conclude the authors, "should consider treating pain more aggressively in children with arthritis with standard pharmacologic therapies." The scientists also recommend "therapeutic interventions to treat anxiety, including psychotropic medication and cognitive-behavioral therapy."

The two-month study, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the Office of Research on Women's Health (ORWH) and the private sector, involved 41 children with juvenile arthritis. Key components of the study were new assessment tools and a patient diary. Diary analysis in conjunction with standard clinical testing showed that increased anxiety-and, surprisingly, not depressed mood-was significantly associated with increased fatigue and pain frequency and intensity.

Juvenile arthritis is one of the most prevalent chronic diseases in children in the United States. While arthritis pain has been the focus of much research in adults, there is an increasing awareness of the need to focus on pain in children. Children with juvenile arthritis may have pain that can be intense and disabling, and comprehensive treatment optimizes their ability to fully participate in school and social activities.

The NIAMS and the ORWH are part of the U.S. Department of Health and Human Services' National Institutes of Health, the leading Federal agency in biomedical and behavioral research.

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Schanberg L, Anthony K, Gil K, and Maurin E. Daily pain and symptoms in children with polyarticular arthritis. Arthritis and Rheumatism, 2003; 48(5):1390-97.