Psychosocial aspects of juvenile rheumatoid arthritis.

The earliest studies dating back to the 1950s have tended to present a more pessimistic view of the psychosocial aspects of JRA patients. More carefully designed studies, however, have shown that these children do not have unique personality characteristics, nor are they necessarily socially maladjusted. Stress may play some role in onset of exacerbation of the disease, although this role is unclear at present. The child's level of cognitive development probably does play a role in the perception of pain and should be considered when undertaking patient education. The long-term psychosocial outcome of JRA patients appears to be quite good, with the majority of patients achieving educational levels at or beyond the level of the population as a whole and with the majority of patients able to support themselves. Future research may provide tools for even better assessment of this and other areas of psychosocial function.