The psychophysical impact of COVID-19 lockdown on pediatric patients with rheumatological disease

Background: COVID-19 was declared a pandemic on 11 March 2020 and unprecedented containment measures were taken to limit its spreading. These exceptional measures may have an impact on the mental health of the population. Objectives: We hypothesize that children with the rheumatological chronic disease might be a population at higher risk of psychological distress. Design: This study evaluated the psychological effect of social distancing in pediatric rheumatological patients and its possible correlation with disease relapse. Setting: Pediatric patients diagnosed with juvenile idiopathic arthritis (JIA) were included in the study. Subjects and methods: They completed the Multidimensional Anxiety Scale for Children (MASC-2) to assess anxious symptoms, the Children Depression Inventory Self Report (CDI-2 SR) for depression symptoms and a semi-structured questionnaire to collect their activities. Their parents completed the Children Depression Inventory 2 Parent (CDI-2 P). Results: The MASC-2 test showed high values in anxiety factors. The CDI-2 SR test showed high values for Ineffectiveness and Functional Problems. The CDI-2 P showed high values for Emotional Problems factor. All the patients with high level of depression were females. The result is that those who take therapy were younger, have reduced values in Functional Problems and in Social Anxiety. 47% of the sample had disease relapse. Conclusions: During the COVID-19 period of isolation, in patients with JIA, there was an increase in anxious and depressive symptoms in female adolescents, a tendency to disease relapse, despite generally good compliance to therapy. Those under treatment were younger and showed reduced values in Functional Problems, Social Anxiety, and Humiliation/Rejection. Limitations: Limited number of patients to whom questionnaires could be distributed.