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Background: Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease, which can manifest as deformities from an early age. This implies that many of these children may encounter bullying or even physical violence in the school environment. Objectives: This study aimed to assess the prevalence of school-based verbal and physical abuse in children with JIA, and to investigate the impact of such abuse on disease activity and quality of life. Methods: This was a single-center, cross-sectional study including children with JIA diagnosed according to the criteria of the International League of Associations of Rheumatology (ILAR) classification. Quality of life was assessed using the Pediatric Quality of Life Inventory 4.0 (PedsQL4), a 23-item questionnaire. Higher scores indicate a better quality of life. The Childhood Health Assessment Questionnaire (C-HAQ) was used to assess functional disability. The Peer Interaction in Primary School Questionnaire (PIPSQ) was used to assess children's levels of bullying and victimization in the school environment. This score comprises two subscales: a victim scale, where higher scores indicate greater victimization. And a stalker scale where higher scores indicate more acts of violence. Results: Thirty-six patients were recruited. Mean age was 13.5 ± 5.9 years, with a female predominance of 55.6%. The polyarticular form was the most frequent (52.8%), followed by the oligoarticular form (13.9%), then the enthesitis-related form (12.4%). The mean disease duration was 5.5±4.7 years. Median PedsQL4 was 65.8 (IQR= 43.2-90.4). The median C-HAQ was 1 (IQR=0- 2). Of the 36 patients, 44.4% were victims of harassment and 16.6% were perpetrators. These acts of violence were moral in 81.8% and physical in 9.2%. Three patients (8.3%) were absent because of bullying, and 11.1% said they were still afraid to go to school. Factors significantly associated with victimization were: high disease activity (p=0.003), presence of joint deformities (p=0.02), higher C-HAQ score (p=0.001), and impaired quality of life (pConclusion: School violence in children with juvenile idiopathic arthritis is a relatively unexplored issue in the literature. According to our study, bullying, both moral and physical, can have a profound impact on quality of life and disease stability. Raising awareness among peers and parents could help identify opportunities for anti-bullying interventions. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
Ghali et al. (Sat,) studied this question.