What predicts negative effects of rheumatoid arthritis? A follow-up two years after diagnosis

Abstract

We aimed at analyzing important predictive factors for experienced negative emotional and social effects of rheumatoid arthritis (RA) two years after diagnosis in patients aged 18–65 years. The first group included 41 participants, who had psychosocial problems (PSP) already at diagnosis, and who received an intervention by a medical social worker to improve coping capacity and social situation. The second group included 54 patients (NPSP) without such problems at diagnosis. All completed a questionnaire mapping their social situation, the Hospital Anxiety and Depression Scale (HADS), the Sense of Coherence Scale (SOC) and the General Coping Questionnaire (GCQ) at diagnosis and after 24 months. The most pronounced predictive factor for a strong impact of the disease was high scores on HADS depression scale. After 24 months, PSP participants had a more strained life situation, with higher scores on anxiety and depression and lower on SOC, in comparison with NPSP. NPSP participants improved their coping strategies regarding self-trust, cognitive revaluation, protest and intrusion, but deteriorated regarding problem focusing and social trust. PSP patients kept their initial coping strategies, except for intrusion decreasing over time, and seemed to have a more rigid coping pattern. However, the experienced negative impact of the disease increased over time in both groups despite improvement in sickness related data. Mostly influenced areas were economy, leisure time activities and social life. We conclude that psychosocial consequences of RA are more connected to emotional and social vulnerability than are RA-related clinical factors.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-118) contains supplementary material, which is available to authorized users.

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.…”

An appraisal-based coping model of attachment and adjustment to arthritis

“…Because functional limitations are a common stressor for people with arthritis, social support is one coping resource that may be particularly important. Low levels of social support have been implicated in long-term functional disability and pain (Evers, Kraaimaat, Geenen, Jacobs, & Bijlsma, 2003a), psychological distress shortly after diagnosis (Evers, Kraaimaat, Geenen, & Bijlsma, 1997), and longitudinally over several years (Benka et al, 2012;Evers, Kraaimaat, Geenen, Jacobs, & Bijlsma, 2003b;Gafvels, Hagerstrom, Nordmark, & Wandell, 2014) in people with arthritis. However, social support may have to be first perceived and then used to facilitate healthy coping and adjustment (Curtis, Groarke, Coughlan, & Gsel, 2004;Kool, van Middendorp, Lumley, Bijlsma, & Geenen, 2013).…”

Pain rather than self-reported sedentary time explains variation in perceived health and activity limitation in persons with rheumatoid arthritis: a cross sectional study in Sweden

“…Another limitation to our study is the lack of disease activity data, which were only available from the SRQ at a matching point in time for less than 50% of the study sample. It can thus not be excluded that disease activity contributes in explaining the assessed health outcomes, although this has not been the case in all studies on RA using multivariate approaches [ 49 , 50 ]. The external validity of the study may be threatened by the small, but systematically skewed, data towards poorer health in the non-responders.…”