Document Type

Article

Publication Date

8-2025

Identifier

DOI: 10.1002/acr.25519; PMCID: PMC12307100

Abstract

OBJECTIVE: Pediatric rheumatologic diseases (PRDs) are characterized by high rates of anxiety and depression known to impact health-related outcomes. We present guidance statements to assess and manage mental health concerns for youth with PRDs in pediatric rheumatology practice.

METHODS: Development of the guidance statements was initiated in 2019 and concluded in November 2023. It included (1) the formation of a task force (including pediatric rheumatologists, pediatric behavioral health providers, patients, and parents) led by two licensed pediatric psychologists and two board-certified pediatric rheumatologists, (2) iterative drafting of statements and rating of evidence based on the Oxford Centre for Evidence-Based Medicine levels of evidence, (3) an open comment period followed by revision of statements, (4) a Delphi panel process to attain consensus on the statements, and (5) review by the American College of Rheumatology (ACR) Committee on Quality of Care and refinement of statements to an identified list of those with the strongest empiric evidence for endorsement by the ACR.

RESULTS: The task force drafted 34 statements for addressing mental health concerns in pediatric rheumatology, including identification, management, and clinic environment/education considerations. After two rounds of Delphi panel voting by a random sample of 76 members of the Childhood Arthritis and Rheumatology Research Alliance, 31 statements attained at least 80% consensus. Eleven of those statements had high empirical support and endorsement and were thus selected as the final guidance statements, including recommendations for depression and anxiety screening in youth aged 12 years and older, management of identified symptoms, and education of patients about mental health.

CONCLUSION: It is a goal that these recommendations be used to empower pediatric rheumatology teams to consider how they may better address mental health concerns in their setting and help improve both mental health- and health-related outcomes for youth with rheumatologic diseases.

Journal Title

Arthritis Care Res (Hoboken)

Volume

77

Issue

8

First Page

953

Last Page

964

MeSH Keywords

Humans; Rheumatic Diseases; Rheumatology; Mental Health; Adolescent; Child; Consensus; Pediatrics; Delphi Technique; United States

PubMed ID

40051122

Keywords

Rheumatic Diseases; Rheumatology; Mental Health; Consensus; Pediatrics; Delphi Technique; United States

Comments

Grants and funding

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Publisher's Link: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr.25519

Download

Share

COinS