The aim of this study is to investigate whether methotrexate-induced nausea is associated with anxiety or the use of coping strategies in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX). This is an observational study of children diagnosed with JIA (ILAR criteria), treated with MTX and aged 9 years or above. MTX-induced nausea was determined by the children's completion of a nausea diary and the parents' completion of the Methotrexate Intolerance Severity Score (MISS). Anxiety was assessed by the Beck Youth Inventories-Anxiety Inventory (BYI-A) and coping strategies were evaluated by an adapted Nausea Coping Questionnaire. Enrolled were 121 children (82 girls: 39 boys) with a median age (IQR) of 13.3 (11.3-15.1) years. The median MTX-dose (IQR) was 9.7 (9.0-10.9) mg/m2/week. The median treatment duration (IQR) was 340 (142-766) days. The MISS was completed for 120 children; 77 children completed the nausea diary for at least 7 days. MTX-induced nausea was present in 61% (73/120) of the children according to the MISS and in 73% (56/77) of the children according to the nausea diary. MTX-induced nausea was associated with a more frequent use of the coping strategy internalizing/catastrophizing (MISS, p = 0.012; diary, p < 0.0001) and higher BYI-A raw scores (diary, p = 0.016). MTX-induced nausea was associated with anxiety and the use of coping strategies in children with JIA. These psychological factors may be part of the mechanism behind the inter-individual variation in the level of nausea to MTX treatment.

中文翻译：

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少年特发性关节炎的应对策略和焦虑症与甲氨蝶呤引起的恶心相关。

这项研究的目的是调查甲氨蝶呤（MTX）治疗的儿童特发性关节炎（JIA）患儿是否与甲氨蝶呤引起的恶心相关联或与应对策略的使用有关。这是一项对被诊断为JIA（ILAR标准），接受MTX治疗且年龄在9岁或以上的儿童的观察性研究。MTX引起的恶心是由孩子的恶心日记的完成情况和父母对甲氨蝶呤耐受性严重程度评分（MISS）的完成情况决定的。焦虑由Beck青年调查表-焦虑调查表（BYI-A）评估，应对策略由改编的恶心应对调查表评估。入组儿童121位（82位女孩：39位男孩），平均年龄（IQR）为13.3（11.3-15.1）岁。平均MTX剂量（IQR）为9.7（9.0-10.9）mg / m2 /周。中位治疗时间（IQR）为340（142-766）天。MISS已为120名儿童完成；77名儿童至少在7天内完成了恶心日记。根据MISS，MTX引起的恶心存在于61％（73/120）的儿童中，而根据恶心日记则存在于73％（56/77）的儿童中。MTX引起的恶心与应对策略内化/灾难性使用更为频繁（MISS，p = 0.012；日记，p <0.0001）和更高的BYI-A原始评分（日记，p = 0.016）。MTX引起的恶心与JIA儿童的焦虑和应对策略的使用有关。这些心理因素可能是MTX治疗引起的恶心程度个体差异背后机制的一部分。77名儿童至少在7天内完成了恶心日记。根据MISS，MTX引起的恶心存在于61％（73/120）的儿童中，而根据恶心日记则存在于73％（56/77）的儿童中。MTX引起的恶心与应对策略内化/灾难性使用更为频繁（MISS，p = 0.012；日记，p <0.0001）和更高的BYI-A原始评分（日记，p = 0.016）。MTX引起的恶心与JIA儿童的焦虑和应对策略的使用有关。这些心理因素可能是MTX治疗引起的恶心程度个体差异背后机制的一部分。77名儿童至少在7天内完成了恶心日记。根据MISS，MTX引起的恶心存在于61％（73/120）的儿童中，而根据恶心日记则存在于73％（56/77）的儿童中。MTX引起的恶心与应对策略内化/灾难性使用更为频繁（MISS，p = 0.012；日记，p <0.0001）和更高的BYI-A原始评分（日记，p = 0.016）。MTX引起的恶心与JIA儿童的焦虑和应对策略的使用有关。这些心理因素可能是MTX治疗引起的恶心程度个体差异背后机制的一部分。MTX引起的恶心与应对策略内化/灾难性使用更为频繁（MISS，p = 0.012；日记，p <0.0001）和更高的BYI-A原始评分（日记，p = 0.016）。MTX引起的恶心与JIA儿童的焦虑和应对策略的使用有关。这些心理因素可能是MTX治疗引起的恶心程度个体差异背后机制的一部分。MTX引起的恶心与应对策略内化/灾难性使用更为频繁（MISS，p = 0.012；日记，p <0.0001）和更高的BYI-A原始评分（日记，p = 0.016）。MTX引起的恶心与JIA儿童的焦虑和应对策略的使用有关。这些心理因素可能是MTX治疗引起的恶心程度个体差异背后机制的一部分。