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J Rheumatol. 2013 Apr;40(4):528-34. doi: 10.3899/jrheum.120741. Epub 2013 Feb 15.

Psychological intervention for adolescents with juvenile idiopathic arthritis: for whom and when?

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Department of Pediatric Psychology, University Medical Center Utrecht, Utrecht, The Netherlands.



To study which adolescents with juvenile idiopathic arthritis (JIA) benefit from psychological intervention, and what is the best moment for it.


In 3 months, 28 adolescents with JIA and 14 healthy adolescents as a control group received psychological intervention with the Self-confrontation Method (SCM), which combines the personal narrative with its affective structure. The adolescents with JIA were split into groups with low health-related quality of life (HRQOL) and high HRQOL. The Child Health Questionnaire, Checklist Individual Strength, and Childhood Health Assessment Questionnaire were used to measure fatigue and physical and psychosocial functioning at baseline, and at 3 months and 9 months after baseline.


Adolescents with JIA and low HRQOL at baseline reported less fatigue and better HRQOL after psychological intervention. These changes could not be explained by changes in disease activity. Low HRQOL at baseline was associated with a more recent onset of JIA, higher levels of pain, more severe physical disability, and higher levels of fatigue.


Two-thirds of adolescents with JIA function well before and after psychological intervention. One-third of adolescents with JIA reporting low HRQOL at baseline benefit from guided self-reflections and should be the focus of psychological intervention. The most effective moment for this psychological intervention is when the adolescent reports difficulties in HRQOL.

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