Psychosocial problems among newly diagnosed rheumatoid arthritis patients

Abstract

We identified patients with newly diagnosed rheumatoid arthritis (RA) in the ages 18-65 years who needed psychosocial interventions. A total of 123 patients (90 women) were asked to participate, but 19 declined and 4 dropped out early in the study, leaving a total of 100 patients (75 women) in the sample. Questionnaires used were the Epidemiological Investigation on Rheumatoid Arthritis study questionnaire, the Hospital Anxiety and Depression Scale, the Sense of Coherence (SOC) scale, and the General Coping Questionnaire. Interviews showed that 46% of the included 100 patients had psychosocial problems (PSP). One third of them had problems directly related to RA. The rest had problems with their life situation in general, without or reinforced by RA. Compared to patients without psychosocial problems, PSP patients lived in more strained social situations, especially regarding personal finances and social support. More of the PSP patients were anxious, showed lower SOC scores, and also used more emotion-based coping strategies (resignation, protest, isolation and intrusion) and less problem-oriented (minimization). They also had higher scores on depression and more frequently expected that RA would negatively affect their future. PSP patients also experienced a more negative impact of the disease, a finding not confirmed by the sickness activity score judged by the rheumatologist. Thus, early in the course of RA, screening instruments should be used to identify PSP patients. Psychosocial treatment and support by medical social workers skilled in RA care should be offered.

Predictors of Pain for Patients With Early Inflammatory Polyarthritis

“…Surprisingly, age was negatively associated with pain modalities at baseline only. One would reason that younger individuals may initially react more intensely to pain and loss of function (6), but that later on, other individual variables (such as coping or depression) would matter more. This is noteworthy, since we previously observed that increasing age positively correlated with radiologic and functional severity in patients with EIP (16,33).…”

“…Similarly, patients who have comparable evidence for disease activity or functional impairment may react differently (3); one patient may continue to work, whereas another may reduce hours, or retire early. For example, arthritis patients with psychological distress are more likely to experience and be disabled by pain (5,6). Lee et al (7) found that even when in remission, 12% of patients with RA report significant levels of pain that are associated with global functioning, fatigue, sleep problems, and poor self-efficacy for dealing with the disease.…”

Depression and anxiety after 2 years of follow-up in patients diagnosed with diabetes or rheumatoid arthritis

“…This study is based on a prospective study of the psychosocial consequences of DM and RA (Gafvels et al, 2012, 2014a, 2014b; Rane et al, 2011). All measurements were performed at inclusion and after 24 months.…”

“…All measurements were performed at inclusion and after 24 months. DM patients in the study were recruited from the Diabetes Outpatient Centre at Karolinska University Hospital, Solna (Rane et al, 2011), and RA patients were recruited from the Early Arthritis Clinic at the Department of Rheumatology, Karolinska University Hospital, Solna (Gafvels et al, 2012). Recruitment took place between January 2001 and December 2004.…”

Impairment and Disability: Renoir's Adaptive Coping Strategies against Rheumatoid Arthritis

“…In a study on newly diagnosed rheumatoid patients, Gåfvels et al found that over half of the study participants had psychosocial problems severe enough to warrant some type of psychological intervention [10]. This demonstrates the serious impact arthritis can have on a patient's quality of life and the importance of the emotional coping component.…”