Juvenile rheumatoid arthritis: pain-related and psychosocial aspects and their relevance for assessment and treatment

Objective. To review literature in the area of juvenile rheumatoid arthritis that has focused on pain experience, functional losses, and psychosocial functioning. Methods. This article provides a critical review of research addressing these three primary issues. Results. Subjective and behavioral measures have been developed to assess pain in juvenile rheumatoid arthritis patients, but further work is needed to determine the validity and reliability of these instruments. Tools to assess functional losses in juvenile rheumatoid arthritis patients also appear promising in preliminary studies. Patients can be at risk for difficulties in psychosocial functioning, although research suggests that there are a variety of family, parental, and child variables that influence child and sibling adaptation. Methodologic shortcomings prevent definitive conclusions in this area. Conclusions. Although methodologic limitations have plagued this research in the past, new advances are facilitating improved understanding of children and adolescents with juvenile rheumatoid arthritis. Implications for future study with this challenging population are offered.