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The adolescent with rheumatic disease
  1. R Sathananthan,
  2. J David
  1. Royal Berkshire and Battle Hospitals NHS Trust, Reading, Berkshire
  1. Dr J David, Royal Berkshire and Battle Hospitals NHS Trust, Oxford Road, Reading, Berkshire RG3 1AG.

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Adolescence is the period between childhood and adulthood when major biological and psychosocial development occurs. During childhood, toddlers are initially wholly dependent on their parents to meet their everyday needs, such as washing, dressing, and feeding. As the child grows, so the parental role needs to accommodate these changes.

Puberty results in skeletal growth, maturation, and the development of secondary sex characteristics. Teenagers are extremely sensitive to the opinions of their peers and will often compare themselves with others. Even the perception, real or otherwise, of underdevelopment, obesity, or acne can lead to feelings of inferiority, low esteem, and loss of confidence. Awareness of self and body image, as well as a concept of sexuality, becomes important. Seeking friends and sexual relationships, plans for the future, and career choices need to be made. There is an increasing need for independence and a separate identity from the parents. Adulthood signifies this independence—often the completion of education, starting of employment, financial independence, leaving home, and the possibility of making a contribution to society.

Adolescents with chronic illness and disability may be more dependent on their parents for support. They may also feel overprotected, sheltered, and unable to make their own decisions. They may sense a general lack of control in their lives as they struggle to seek their own independence. Self consciousness about physical appearance often leads to withdrawal and an inability to socialise. Frequent admissions to hospital contribute to social isolation and loneliness. Career opportunities may be limited further increasing reliance on the family and community for financial support.

Juvenile chronic arthritis

Although there are conditions that are exclusive to the young, most rheumatic diseases form part of a continuum with those seen in adulthood. The pattern of arthritis can sometimes be predicted, depending on the age and sex of the patient.

Juvenile chronic …

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Footnotes

  • This is the sixth article in a series on rheumatology.