Rheumatoid Arthritis, Personality, Stress Response Style, and Coping with Illness: A Preliminary Survey

This review highlights the issue of psychosomatic conditions in rheumatoid arthritis, paying special attention to new researches and trends in this field. Emerging concepts in all the major parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain on the emotional state to disease influence over quality of life, socio-psychological, and interpersonal relationships. Chronic pain is closely related to emotional responses and coping ability, with a pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading to further decrease in quality of life, low compliance, and high suicide risk. Influence of psychosomatic conditions on the overall treatment effect is usually underestimated by rheumatologists and general practitioners. Psychosomatic considerations are of great importance for up-to-date management of rheumatoid arthritis, as they strongly influence the quality of life, compliance, and thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping with pain through the regulation of emotion and psychotherapeutic intervention, which not only helps patients in coping with the disease, but also aimed at improving the overall adaptation of the patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy. Current data about the efficacy of the additional correcting therapies for patients with rheumatoid arthritis, both emerging and common ones, are discussed in the review.

Download Full-text

Acute cold stress in rheumatoid arthritis inadequately activates stress responses and induces an increase of interleukin 6

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.089458 ◽

2008 ◽

Vol 68 (4) ◽

pp. 572-578 ◽

Cited By ~ 16

Author(s):

R H Straub ◽

G Pongratz ◽

H Hirvonen ◽

T Pohjolainen ◽

M Mikkelsson ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Stress Response ◽

Cold Stress ◽

Stress Responses ◽

Plasma Levels ◽

Acute Stress ◽

Whole Body ◽

Cold Therapy ◽

Before And After ◽

Sympathetic Stress

Objective:Acute stress in patients with rheumatoid arthritis (RA) should stimulate a strong stress response. After cryotherapy, we expected to observe an increase of hormones of the adrenal gland and the sympathetic nervous system.Methods:A total of 55 patients with RA were recruited for whole-body cryotherapy at −110°C and −60°C, and local cold therapy between −20°C and −30°C for 7 days. We measured plasma levels of steroid hormones, neuropeptide Y (sympathetic marker), and interleukin (IL)6 daily before and after cryotherapy.Results:In both therapy groups with/without glucocorticoids (GC), hormone and IL6 levels at baseline and 5 h after cold stress did not change over 7 days of cryotherapy. In patients without GC, plasma levels of cortisol and androstenedione were highest after −110°C cold stress followed by −60°C or local cold stress. The opposite was found in patients under GC therapy, in whom, unexpectedly, −110°C cold stress elicited the smallest responses. In patients without GC, adrenal cortisol production increased relative to other adrenal steroids, and again the opposite was seen under GC therapy with a loss of cortisol and an increase of dehydroepiandrosterone. Importantly, there was no sympathetic stress response in both groups. Patients without GC and −110°C cold stress demonstrated higher plasma IL6 compared to the other treatment groups (not observed under GC), but they showed the best clinical response.Conclusions:We detected an inadequate stress response in patients with GC. It is further shown that the sympathetic stress response was inadequate in patients with/without GC. Paradoxically, plasma levels of IL6 increased under strong cold stress in patients without GC. These findings confirm dysfunctional stress axes in RA.

Download Full-text

Mothers’ Experiences of Wellbeing and Coping While Living with Rheumatoid Arthritis: A Qualitative Study

10.21203/rs.3.rs-690060/v1 ◽

2021 ◽

Author(s):

Chloe Parton ◽

Jane M. Ussher ◽

Janette Perz

Keyword(s):

Rheumatoid Arthritis ◽

Social Support ◽

Structured Interview ◽

Older Children ◽

Dependent Child ◽

Women’S Experiences ◽

Women's Experiences ◽

Qualitative Thematic Analysis ◽

Letting Go ◽

And Coping

Abstract Background Rheumatoid arthritis (RA) can result in difficulties for mothers when undertaking daily care activities and increased psychological distress. However, few studies have examined how women with RA subjectively experience coping and wellbeing as part of their motherhood. Methods Twenty mothers with a diagnosis of RA and a dependent child (18 years or younger) who were living in Australia took part in a semi-structured interview between June and November 2017. Purposive sampling was undertaken to include participants across degree of current RA severity, number and age of children, and having received a diagnosis before or after a first child to take account of variability across these experiences. A qualitative thematic analysis was conducted on the interview transcripts. Results The following themes were identified: ‘Burden and complexity in the mothering role’, ‘Losing control: Women’s experiences of distress’, and ‘Adjusting and letting go: Women’s experiences of wellbeing’. Experiences of distress, including feelings of failure, were associated with accounts of a loss of control over mothering practices among women, regardless of child age. In contrast, accounts of adjusting mothering practices and relinquishing control were associated with reports of enhanced wellbeing. In addition, some mothers reported greater ease due to increased independence of older children. The absence of social support exacerbated burden and distress in the women’s accounts, while the availability of support alleviated burden and was associated with reports of wellbeing. Conclusion Health professionals and services can provide support to mothers with RA by addressing feelings of failure, acknowledging strategies of adjustment and letting go, and encouraging access to social support.

Download Full-text

Acute Stress Response of Individuals to Public Health Emergencies: Characteristics and Coping Approach

Advances in Psychology ◽

10.12677/ap.2021.116152 ◽

2021 ◽

Vol 11 (06) ◽

pp. 1358-1366

Author(s):

馨予张

Keyword(s):

Public Health ◽

Stress Response ◽

Acute Stress ◽

Public Health Emergencies ◽

Acute Stress Response ◽

And Coping

Download Full-text

SAT0090 EFFECTS OF ADHERENCE TO MEDITERRANEAN DIET ON RHEUMATOID ARTHRITIS IMPACT OF DISEASE (RAID) SCORE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2338 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 979.1-979

Author(s):

F. Ingegnoli ◽

I. Scotti ◽

T. Schioppo ◽

T. Ubiali ◽

G. Marano ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mediterranean Diet ◽

Functional Disability ◽

Regression Coefficient ◽

Well Being ◽

P Value ◽

Food Groups ◽

Single Item ◽

And Coping ◽

The Relationship

Background:Mediterranean diet (MD) is a well-balanced, nutritionally adequate and potentially anti-inflammatory diet that encompasses all food groups. Presently, there are conflicting data about the benefits of MD in rheumatoid arthritis (RA). Not enough evidence support a role of MD in the prevention and treatment of RA, and a modest impact of MD on laboratory parameters has been described. Greater effect on subjective aspects of the disease such as joint pain, morning stiffness, and fatigue was reported.Objectives:To investigate whether the adherence to MD affects RA perception as measured by Rheumatoid Arthritis Impact of Disease (RAID) score.Methods:Consecutive patients <65 years with RA attending our outpatient clinic were enrolled in this cross-sectional study. For each patient we collected: 1) RAID that consists of 7 single-item domains (pain, functional disability, fatigue, sleep, physical well-being, emotional well-being and coping), each rated by patients on an 11-point numerical rating scale from 0 (best) to 10 (worst) [1], and 2) MD score, a self-reported questionnaire that evaluates the adherence to MD through the consumption of 11 food groups, ranging from 0 (no adherence) to 55 (high adherence) [2]. Univariate analysis was performed using MD score as independent variable. Moreover, to evaluate the adjusted relationship between the single item of RAID and MD score, a multiple regression model was used.Results:205 RA patients were enrolled: median age at visit 53 (q1-q3: 44-59) years, female 80.5 %. The median MD and RAID score were 35 (q1-q3: 32-39) and 2.42 (q1-q3: 0.63-4.51) respectively.RAID total score had a statistically significant negative relationship with MD score (regression coefficient -0.08; p-value=0.016). Concerning the single RAID items, a statistically significant negative association was found for pain (regression coefficient -0.08; p-value=0.025), functional disability (regression coefficient -0.13; p-value<0.001), sleep (regression coefficient -0.08; p-value=0.041), physical well-being (regression coefficient -0.08; p-value=0.027) and coping (regression coefficient -0.11; p-value=0.008).Multiple regression analysis to evaluate the relationship between significant RAID items and MD score did not show any statistical significance as all items are strongly related to each other.Conclusion:To our knowledge, this is the first study addressing the relationship between the adherence to MD and the perception of RA impact. A better MD adherence was associated with lower self-reported composite total RAID score as well as lower pain, functional disability, sleep, physical well-being and coping. The effect of MD adherence on overall RAID is relevant but, at the same time, a prominent effect of one single item on the others could not be documented. This study confirmed the importance of non-pharmacological interventions, such as diet, in RA management.References:[1] Gossec L, et al. Ann Rheum Dis 2011;70(6):935-42.[2] Panagiotakos DB, et al. Nutr Metab Cardiovasc Dis 2006;16(8):559-68.Disclosure of Interests:Francesca Ingegnoli: None declared, Isabella Scotti: None declared, Tommaso Schioppo: None declared, Tania Ubiali: None declared, Giuseppe Marano: None declared, Patrizia Boracchi: None declared, Orazio De Lucia: None declared, Antonella Murgo: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

Download Full-text

Age, pain, and coping with rheumatoid arthritis

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/s0161-4754(00)90268-9 ◽

2000 ◽

Vol 23 (3) ◽

pp. 224

Keyword(s):

Rheumatoid Arthritis ◽

And Coping

Download Full-text

Impact of maltreatment on depressive symptoms in young male adults: The mediating and moderating role of cortisol stress response and coping strategies

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2018.12.235 ◽

2019 ◽

Vol 103 ◽

pp. 41-48 ◽

Cited By ~ 3

Author(s):

Christina Y. Cantave ◽

Stephanie Langevin ◽

Marie-France Marin ◽

Mara Brendgen ◽

Sonia Lupien ◽

...

Keyword(s):

Depressive Symptoms ◽

Stress Response ◽

Coping Strategies ◽

Young Male ◽

And Coping ◽

Moderating Role

Download Full-text

One in five patients with rapidly and persistently controlled early rheumatoid arthritis report poor well-being after 1 year of treatment

RMD Open ◽

10.1136/rmdopen-2019-001146 ◽

2020 ◽

Vol 6 (1) ◽

pp. e001146 ◽

Cited By ~ 1

Author(s):

Kristien Van der Elst ◽

Patrick Verschueren ◽

Diederik De Cock ◽

An De Groef ◽

Veerle Stouten ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Early Rheumatoid Arthritis ◽

Illness Perceptions ◽

Treatment Initiation ◽

Well Being ◽

Current Treatment ◽

Treatment Standards ◽

Patient Reported ◽

And Coping

ObjectivesTo identify and characterise a subgroup of patients with early rheumatoid arthritis (RA) reporting not feeling well 1 year after treatment initiation despite achieving optimal disease control according to current treatment standards.MethodsThis observational study included participants of the Care in early RA trial with a rapid and sustained response (DAS28CRP<2.6) from week 16 until year 1 after starting the first RA treatment. Feeling well was assessed at year 1, using five patient-reported outcomes (PROs): pain, fatigue, physical functioning, RA-related quality of life and sleep quality. K-means clustering assigned patients to a cluster based on these PROs. Cohen’s d effect size estimated cluster differences at treatment initiation and week 16, for the five clustering PROs, coping behaviour, illness perceptions and social support.ResultsAnalyses revealed three clusters. Of 140 patients, 77.9% were assigned to the ‘concordant to disease activity’ cluster, 9.3% to the ‘dominant fatigue’ cluster and 12.9% to the ‘dominant pain and fatigue’ cluster. Large differences in pain and fatigue reporting were found at week 16 when comparing the ‘concordant’ with the ‘dominant pain and fatigue’ or the ‘dominant fatigue’ cluster. Small differences in reporting were found for the other PROs. Illness perceptions and coping style also differed in the ‘concordant’ cluster.ConclusionsAlthough most patients reported PRO scores in concordance with their well-controlled disease activity, one in five persistent treatment responders reported not feeling well at year 1. These patients reported higher pain and fatigue, and different illness perceptions and coping strategies early in the disease course.

Download Full-text