Chronic Stress and Arthritis: A Scoping Review

Abstract

Objective. Emerging research supports the role of chronic stress in chronic disease development. The objective was to perform a scoping review mapping the field of research exploring relationships between chronic stress and the development of arthritis in adult populations.Methods. Five electronic databases were systematically searched without publication limits based on 3 key concepts: stress, arthritis, and adults. Eligible qualitative studies investigated individuals' perceived causes of arthritis; quantitative studies investigated relationships between exposure to a chronic stressor and an arthritis presence outcome. Articles were screened by 2 independent reviewers, and data were narratively synthesized.Results. Of 1,819 unique records, 54 studies met inclusion criteria. Nine studies used qualitative methods, and 45 used quantitative methods. The frequency of studies increased chronologically, with half (n = 27) published since 2010. Chronic stress exposures were heterogenous; most were categorized as adverse life events (n = 22) or adverse childhood experiences (n = 17). Self-reported arthritis was the most frequent measure of arthritis outcome (n = 26) in quantitative studies. A majority of studies (n = 41) suggested a relationship between exposure to chronic stressors and arthritis development.Conclusion. Increasing study numbers in the past decade may reflect increasing awareness of the potential impact of chronic stress in arthritis development, consistent with a biopsychosocial approach to chronic disease etiology and management. Further research, using precise arthritis definitions, conducted within a clearly articulated pathophysiologic framework, is required to establish a causal relationship between exposure to chronic stressors and the development of specific arthritis conditions.

Associations of Rheumatoid Arthritis and Depressive Symptoms Over Time: Are There Differences by Education, Race/Ethnicity, and Gender?

“…Since the late 1990s, advances in drug therapies have contributed to improved outcomes for patients with RA; however, some still have considerable physical and mental health effects from RA (3,4). Depression is more common among individuals with RA than in the general population, and although numerous studies document the physiology of RA, fewer focus on the dynamic associations of biological, psychological, and social dimensions of RA in a single study (2,4–6).

Changes in pain, functional disability, and household work disability were associated with changes in depressive symptoms for individuals with rheumatoid arthritis. Changes in marital status and employment were associated with changes in depressive symptoms over time. The association between pain and depressive symptoms was stronger for women compared to men; the association between functional disability and depressive symptoms was stronger for men compared to women. Education modifies the association of social support and depressive symptoms; the association was stronger for individuals with lower education. Patients varied in how much pain, functional disability, household work disability, and social circumstances mattered for depressive symptoms.

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Association of childhood physical and sexual abuse with arthritis in adulthood: Findings from a population-based study

“…Our results replicate findings in prior research that suggests an association between adverse childhood events and arthritis among adults ( Dube et al, 2009 , Kopec and Sayre, 2004 , Von Korff et al, 2009 ). These results are further reflected by findings in one recent review indicating that there is growing interest and awareness of the potential impact of early childhood and chronic stress in arthritis development ( Schwetlik et al, 2020 ). Whereas previous research has focused on establishing a dose–response relationship between ACEs related to maltreatment and household dysfunction and adult-onset of arthritis ( Von Korff et al, 2009 ), our findings extend the literature in this field by focusing specifically on CPA and CSA that may have more of an impact on arthritis than other ACE categories such as parental substance use or mental health issues.…”

Peritraumatic Stress From a Disaster Increases Risk for Onset of Chronic Diseases Among Older Adults

“…These physiological responses can in turn lead to early biologic aging and disease ( 27 ). Expert reviews of physiological responses to stress provide robust evidence that stress is associated with the onset of chronic diseases ( 31 ), including cardiovascular disease (CVD) ( 32 ), diabetes ( 33 ), asthma ( 30 ), and arthritis ( 34 ). Yet, little is known about whether exposure to a natural disaster is associated with the onset of chronic diseases in the years following a disaster.…”