A Potential Moderating Role of Stress in the Association of Disease Activity and Psychological Status among Patients with Rheumatoid Arthritis

1998 ◽  
Vol 83 (1) ◽  
pp. 147-157 ◽  
Author(s):  
Manuel A. Arango ◽  
Pablo O. Cano

This study investigated the role of perceived daily stress as a potential moderator in the relation between a set of predictors (disease activity, education, pain) and psychological status (anxiety, depression) of 31 patients with rheumatoid arthritis. Psychological measures served as dependent variables in hierarchical regression analyses testing for potential interaction effects of daily stress upon relationships between predictors and dependent measures. No predictors predicted directly scores on depression and anxiety; however, daily stress directly predicted scores on depression and anxiety, even after having separately controlled for each of the predictors. Increased disease activity had significantly stronger associations with increased psychological morbidity only among patients reporting high scores on daily stress, suggesting a potential moderating role for stress.

Author(s):  
Muhannad Mohammed Ali AL-Salami ◽  
Abeer Thaher Naji AL-Hasnawi ◽  
Mohammed Abd AbdulHussein Abusabe

2018 ◽  
Vol 86 (September) ◽  
pp. 3341-3348
Author(s):  
DALIA B. EL-BOHOTY, M.Sc.; DOAA S. AL-ASHKAR, M.D. ◽  
MAALY M. MABROUK, M.D.; HALA M. NAGY, M.D.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 583-583
Author(s):  
C. Garufi ◽  
F. Ceccarelli ◽  
F. R. Spinelli ◽  
S. Mancuso ◽  
C. Pirone ◽  
...  

Background:In the management of chronic arthritis, such as Rheumatoid Arthritis (RA), Ultrasound (US) assessment can provide relevant information about the joint inflammatory status in the diagnostic phase and even more in the monitoring of disease activity and structural damage1,2.Objectives:In this longitudinal study, we aimed to assesse the role of US in predicting the efficacy of JAK-inhibitors (JAKi) in RA patients.Methods:We enrolled RA patients starting baricitinib or tofacitinib. All patients were evaluated at baseline and after 4, 12, 24, 48 weeks. Disease activity was calculated by DAS28CRP. US examination in 22 joints (I–V MCPs and PIPs, wrists) aimed at evaluating inflammatory features (synovial effusion and hypertrophy, power Doppler-PD), through a semi-quantitative scale (0-3). The total US (0-198) and PD (0-66) scores were calculated. We scanned bilateral flexor (I–V fingers of hands) and extensor compartments (1-6) tendons: tenosynovitis was scored as absent/present (0/1), resulting in a total score (0-22).Results:We studied 102 patients (M/F 15/87; median age 59.2 years, IQR 17.75; median disease duration 144 months, IQR 126), 61 treated with baricitinib and 41 with tofacitinib. At baseline, the median total US score was 18 (IQR 19) and the median PD score 2 (4). We observed a significant reduction in both total and PD US scores at all time-points (p<0.0001) (Figure 1). At baseline, 75.4% of patients showed tenosynovitis involving at least one tendon, with a median score of 2 (IQR 3.5) significantly decreasing after 24 weeks (p=0.02). Multivariate analysis, adjusted for baseline DAS28CRP and other concomitant treatments (including glucocorticoids and methotrexate treatment), confirmed the independent association between baseline US (PD and tenosynovitis) scores and the reduction of disease activity at follow-up evaluations.Conclusion:The present study confirmed the early efficacy of JAKi in RA patients by using US evaluation. Furthermore, power doppler and tenosynovitis scores could play a predictive role in response to treatment.References:[1]MUELLER RB, HASLER C, POPP F, et al. Effectiveness, Tolerability, and Safety of Tofacitinib in Rheumatoid Arthritis: A Retrospective Analysis of Real-World Data from the St. Gallen and Aarau Cohorts. J Clin Med. 2019;8(10):1548.[2]COLEBATCH AN, EDWARDS CJ, ØSTERGAARD M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804-14.Figure 1.Ultrasound inflammatory score (a) and Ultrasound Power Doppler (PD) score (b) at baseline and follow-up.Table 1.Baseline characteristics of 414 RA patients.WEEKS04122448US inflammatory score18 (19)11 (15.5)9.5 (11.7)7.5 (8)6 (11)US PD score2 (4)0 (2)0 (1)0 (1)0 (0.7)Disclosure of Interests:Cristina Garufi: None declared, Fulvia Ceccarelli: None declared, Francesca Romana Spinelli Speakers bureau: Abbvie, Eli Lilly, Consultant of: Gilead/Galapagos, Eli Lilly, Grant/research support from: Pfizer, Silvia Mancuso: None declared, Carmelo Pirone: None declared, Fabrizio Conti Speakers bureau: Abbvie, Eli Lilly, Sanofi, Pfizer, Consultant of: Gilead/Galapagos


2010 ◽  
Vol 37 (4) ◽  
pp. 829-834 ◽  
Author(s):  
TAMAR F. BRIONEZ ◽  
SHERVIN ASSASSI ◽  
JOHN D. REVEILLE ◽  
CHARLES GREEN ◽  
THOMAS LEARCH ◽  
...  

Objective.To investigate the role of psychological variables in self-reported disease activity in patients with ankylosing spondylitis (AS), while controlling for demographic and medical variables.Methods.Patients with AS (n = 294) meeting modified New York criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality, and helplessness. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of the correlation of psychological variables with disease activity, as measured by the Bath AS Disease Activity Index (BASDAI).Results.In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASDAI scores, adding an additional 33% to the overall R-square beyond that accounted for by demographic and medical variables (combined R-square 18%). Specifically, arthritis helplessness and depression accounted for the most significant portion of the variance in BASDAI scores in the final model.Conclusion.Arthritis helplessness and depression accounted for significant variability in self-reported disease activity beyond clinical and demographic variables in patients with AS. These findings have important clinical implications in the treatment and monitoring of disease activity in AS, and suggest potential avenues of intervention.


2010 ◽  
Vol 67 (4) ◽  
pp. 286-290 ◽  
Author(s):  
Aleksandra Tomic-Lucic ◽  
Suzana Pantovic ◽  
Gvozden Rosic ◽  
Zdravko Obradovic ◽  
Mirko Rosic

Background/Aim. Many arguments prove the pathophysiologic role of histamine in the process of remodeling and joint destruction in rheumatoid arthritis. The aim of our study was to find out if there was a relation between histamine concentration in synovial fluid and blood with clinical expression of disease activity. Methods. Histamine concentration in synovial fluid and blood was determinated in 19 patients with rheumatoid arthritis. Histamine concentration measurement was based on the Shore's fluorometric method. Histamine index (HI) was evaluated as a ratio between histamine concentration in synovial fluid and blood. Disease activity score, DAS 28 (3), with three variables (erythrocyte sedimentation rate, the number of swelled joints and the number of tender joints) was also evaluated. Results. Our results showed that there was no significant difference in concentration of histamine in synovial fluid and blood related to disease activity. However, there was a significant difference in the histamine index which was increased proportionally with disease activity. Conclusion. Our study indicates that histamine index could be useful in estimation of rheumatoid arthritis activity.


2018 ◽  
Vol 77 (9) ◽  
pp. 1345-1353 ◽  
Author(s):  
Azita Sohrabian ◽  
Linda Mathsson-Alm ◽  
Monika Hansson ◽  
Ann Knight ◽  
Jörgen Lysholm ◽  
...  

IntroductionIndividual patients with rheumatoid arthritis (RA) show divergent specific anti-citrullinated protein/peptide antibodies (ACPA) patterns, but hitherto no individual ACPA specificity has consistently been linked to RA pathogenesis. ACPA are also implicated in immune complexes (IC)-associated joint pathology, but until now, there has been no method to investigate the role of individual ACPA in RA IC formation and IC-associated pathogenesis.MethodsWe have developed a new technique based on IC binding to C1q-coated magnetic beads to purify and solubilise circulating IC in sera and synovial fluids (SF) from 77 patients with RA. This was combined with measurement of 19 individual ACPA in serum, SF and in the IC fractions from serum and SF. We investigated whether occurrence of individual ACPA as well as number of ACPA in these compartments was related to clinical and laboratory measures of disease activity and inflammation.ResultsThe majority of individual ACPA reactivities were enriched in SF as compared with in serum, and levels of ACPA in IC were regulated independently of levels in serum and SF. No individual ACPA reactivity in any compartment showed a dominating association to clinical and laboratory measures of disease activity and severity. Instead, the number of individual ACPA reactivities in the IC fraction from SF associated with a number of markers of joint destruction and inflammation.ConclusionsOur data highlight the polyclonality of ACPA in joint IC and the possibility that a broad ACPA repertoire in synovial fluid IC might drive the local inflammatory and matrix-degrading processes in joints, in analogy with antibody-induced rodent arthritis models.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dayu Cao ◽  
Yan Zheng ◽  
Chunnian Liu ◽  
Xiaoying Yao ◽  
Shiyue Chen

PurposeThis study aims to identify and describe the relationships among different consumption values, anxiety and organic food purchase behaviour considering the moderating role of sustainable consumption attitude from the viewpoint of the theory of consumption values.Design/methodology/approachData were collected using a structured questionnaire survey in first-tier cities in China. A total of 344 consumers of organic foods participated in the study. Structural equation modelling and hierarchical regression analysis were employed for data analysis.FindingsThe results indicated the significant association of functional value-price, emotional value, social value and epistemic value with purchase behaviour. Anxiety had a positively significant influence on functional (quality), functional (price), emotional, social, conditional and epistemic values. In addition, the results indicated that functional (price), emotional, social and epistemic values played mediating effects in the relationships between anxiety and purchase behaviour. Moreover, sustainable consumption attitude had a positive moderating effect on functional value-price and purchase behaviour.Practical implicationsThe research not only provides novel and original insights for understanding organic consumption but also provides a reference for organic retailers to develop sales strategies and policymakers to formulate policies to guide organic consumption that are conducive to promoting sustainable consumption.Originality/valueFor the first time, this research attempts to explore the relationships among different consumption values, anxiety and purchase behaviour. It may improve the gap of inconsistency in attitude and behaviour in organic consumption, and provide a new perspective for the study of organic consumption.


2019 ◽  
Vol 40 (6) ◽  
pp. 669-683 ◽  
Author(s):  
Qing Xia ◽  
Shumin Yan ◽  
Yuliang Zhang ◽  
Baizhu Chen

Purpose The purpose of this paper is to examine the curvilinear relationship between knowledge leadership and knowledge hiding and the moderating role of psychological ownership on influencing the curvilinear relationship. Design/methodology/approach In total, 403 data were collected from participants in a high-technology company via a two-wave survey. Hierarchical regression analyses were used to test the hypotheses. Findings Results revealed an inverted U-shaped relationship between knowledge leadership and knowledge hiding. The employees exhibited more knowledge hiding in a moderate level of knowledge leadership than in lower and higher levels of knowledge leadership. Moreover, psychological ownership significantly moderated the curvilinear relationship such that the inverted U-shaped relationship was more pronounced among employees with high psychological ownership. Practical implications Employees’ reaction to knowledge leadership may vary from different levels of knowledge leadership. Moreover, organizations should boost employees’ psychological ownership especially for the collective identity that helps them own knowledge as “ours.” Originality/value This study extends both the leadership and knowledge management behavior literatures.


2020 ◽  
pp. 135910532090987 ◽  
Author(s):  
Shirley Regev ◽  
Shmuel Odes ◽  
Vered Slonim-Nevo ◽  
Michael Friger ◽  
Doron Schwartz ◽  
...  

Patients with Crohn’s disease, an inflammatory bowel disease, struggle with chronic somatic symptoms that could bring about emotional distress. This study assessed the relative role of somatization, and depressive and anxiety symptoms in disease activity among 619 Crohn’s patients (18–79 years; 58.3% women). Structural equation modeling revealed that somatization was the only unique predictor of disease activity beyond depression and anxiety. In addition, the effect of somatization on disease activity was stronger in men compared to women. Findings suggest that somatization represents a distinct domain of psychological distress that may play a role in the health of patients with Crohn’s disease.


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