Background: Maternal psychological functioning has been found to be related to psychosocial functioning in children, especially among those whose children have chronic illnesses. Objective: To determine if maternal functioning (operationalized as depression, anxiety and parenting stress) is correlated with children's physical functioning and to assess if this relationship exists when the child's status is assessed independent of maternal report. Methods: Sixty-five mothers of children, ages 1 - 16 years, with JRA completed Ilfeld's Psychiatric Symptom Index (PSI)(assessing maternal depressive symptoms and anxiety) and Abidin's Parenting Stress Index (assessing parenting stress as defined by role restriction and sense of competence). The outcome, children's physical functioning, was measured with two questionnaires; the Childhood Health Assessment Questionnaire (CHAQ), a JRA-specific measure and the Functional Status II (R)(FSII[R]), a general measure of childhood functioning. Mothers were also asked to complete two visual analogue scales (VAS) for pain and global well-being. To determine the child's functioning independent of maternal report, a pediatric rheumatologist examined each child for number of joints with active arthritis and number of joints with limitation of motion, and completed a VAS for disease activity. Results: Associations were found between higher psychiatric symptom scores and several outcomes including larger number of joints with active arthritis (r=.28) and limited joints (r=.25), higher VAS scores for pain (r=.36), poorer functioning on the FSII(R) (r=.37), and high scores on the physician's global assessment (r=.27) (all statistically significant at p<0.05). PSI scores≥30, which suggest a diagnosis of depression, showed a significant association with high VAS scores for pain and poorer functioning on the FSII(R) (p<0.01 for both). The Parenting Stress Index was found to be significantly associated with poorer scores on the CHAQ(r=.28) and the FSII(R) (r=.44) and high scores on the physician's global assessment (r=.38) (p<0.05). Conclusion: Distress in mothers of children with JRA relates to both the child's psychosocial functioning and to their physical functioning. This relationship exists even when the child's physical functioning is assessed independent of maternal report.
