Psychological well‐being in rheumatoid arthritis: a review of the literature

Abstract

The psychological well-being of patients with rheumatoid arthritis (RA) is an important issue, and the advent of measurement tools has led to a better understanding of the mental aspects associated with this chronic illness. Patients with RA are more likely to suffer from anxiety, depression and low self-esteem, with high levels of associated mortality and suicide. The loss of the ability to carry out daily functions owing to RA is also associated with the onset of depressive symptoms. Furthermore, the psychological effects of RA can extend to the partners, families and carers of sufferers. Conventional treatment has focused on treating the symptoms of RA and containment of disease progression, but may not necessarily address the psychological issues associated with the condition. Furthermore, patient perception of RA and of the support offered to them can cause further unnecessary psychological distress. Access to psychological support for RA patients has been shown to be inconsistent and haphazard. It is now being recognized that what is needed is a multidisciplinary team approach to treat psychological distress in RA alongside conventional treatment, involving alternative therapies tailored to the psychological needs of the patient. The benefits of treatments such as cognitive behavioural therapy, meditation and exercise are clear and these treatments should be actively encouraged, thereby enabling patients with RA to better manage the psychological burden associated with this chronic condition.

Perspectives of Vulnerable US Hispanics With Rheumatoid Arthritis on Depression: Awareness, Barriers to Disclosure, and Treatment Options

“…Selfempowerment techniques and approaches were the most preferred, culturally appropriate interventions. While the content of cognitive behavioral treatment interventions has been developed and validated for Hispanics, its delivery should also be tailored to fit the needs of Hispanics with a chronic condition like RA (20,33,34). Focusing on culturally meaningful themes such as coping strategies, stress reduction techniques, positive thinking, selfefficacy, self-esteem, and resilience may facilitate uptake, adherence, and successful outcome (20,33,34).…”

Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)

“…A nursing clinic, specialized in newly diagnosed RA patients, underlined the importance of patients receiving support for their feelings, such as frustration and fear of the future [32]. Investigating psychological well-being [10][11] and emotions [33] in relation to RA is necessary to begin to understand what type of interventions patients can benefit from, and to develop interventions based on patients' experiences of everyday life situations.…”

Cognitive Behavioral Therapy for Patient With Rheumatoid Arthritis and Obesity

“…Being a chronic disease, RA requires adaptation and patients tend to lose hope for a better life as the condition worsens [6]. Such hopelessness is detrimental because it can compromise treatment adherence, increase depression and facilitate the emergence of suicidal ideation or worsen existing suicidal ideation [7,8].…”

“…Patients with chronic diseases have a higher prevalence of depression and anxiety, which contributes to the poor prognosis of the disease and lower treatment adherence [6,7,8]. In RA patients, the presence of depression and anxiety is favored by the aforementioned characteristics of the disease and potential changes in body image, either as a result of changes in the joints or systemic problems due to the medications [9].…”