Disease Activity and Organ Damage in Children with Juvenile Idiopathic Arthritis: The Impact of War-Related Mental Health Disturbances
Holovko T.O.1,2, Bohmat L.F.1,2, Shevchenko N.S.1, Demyanenko M.V.1, Akhnazaryants E.L.1, Nosova O.M.1
- 1State Institution «Institute of Child and Adolescent Health Protection of the National Academy of Medical Sciences of Ukraine», Kharkiv
- 2V.N. Karazin Kharkiv National University, Kharkiv
Summary. Juvenile idiopathic arthritis (JIA) requires a multidisciplinary approach to patient management, long-term follow-up, and aggressive therapy aimed at reducing inflammatory activity, achieving disease remission, and preventing the development of comorbid conditions. In the context of ongoing military conflict, cumulative stress and psychotraumatic factors disrupt adaptive mechanisms and contribute to the formation of comorbid psychosomatic pathology. Objective: to investigate the clinical characteristics and course of juvenile idiopathic arthritis in children with stress-related disorders and impaired adaptation under conditions of armed conflict. Materials and methods. The study included 97 children with JIA aged 8–18 years (52 boys and 45 girls). Oligoarticular JIA was diagnosed in 51 patients (52.6%), and polyarticular JIA in 46 patients (47.4%). Psychosomatic status was assessed using psychodiagnostic methods. Disease course evaluation included assessment of disease activity, clinical and biochemical investigations, echocardiography, and spirometry. Conclusions. During the period of military conflict in Ukraine, children with JIA exposed to war-related stressors demonstrated exacerbation or persistent high activity of the pathological process, along with a wide spectrum of mental disorders. These factors contribute to the development of comorbid conditions and irreversible organ damage. Depressive, anxiety-depressive, and borderline conditions predominated among mental disorders and, without appropriate treatment and support, may progress to more severe psychiatric pathology. Children with JIA and concomitant mental disorders showed a high frequency of cardiovascular, pulmonary, and renal involvement, indicating the need for mandatory monitoring and preventive strategies to limit disease progression.
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