Psychological stress and rheumatoid arthritis in parents after death of a child: a national follow-up study

Objective: To examine the risk of rheumatoid arthritis ( RA) in parents after the death of a child. Methods: All 21 062 parents whose child had died ( younger than 18 years) between 1980 and 1996 in Denmark were included in the bereaved ( exposed) cohort, and 293 745 parents matched on family structure were selected randomly from the general population for the unexposed cohort. Results: We observed 600 incident RA cases during the follow-up ( 35 in the exposed cohort, 565 in the unexposed cohort). The relative risk (RR) of first hospitalisation for RA was 0.88 [95% confidence interval (CI) 0.63 - 1.24]. The RR was close to 1 throughout the 18 years of follow-up. Conclusion: Our findings do not support an association between severe psychological stress and RA.