Early rheumatoid arthritis, personality and psychological status: A follow-up study

This article presents results from a follow-up study in the Netherlands among 292 patients with early rheumatoid arthritis (RA). The main focus of this paper is on (changes in) personality characteristics, coping strategies and psychological status between the first and second wave (T1 and T2). On personality characteristics and psychological status RA patients are compared with a reference group (N=173) from the general community. The levels of self-esteem, neuroticism and social desirability of RA patients were significantly different when compared to those of control subjects. As far as the coping strategies 'emotional expression' and 'confrontation' were concerned, RA patients presented less favourable scores than subjects from the reference group. Along the same line, psychological status was also found to be significantly different in the groups. The results on personality characteristics and psychological status remained stable after 12 months (T2). The patients' functional status appeared to be rather strongly associated only with level of self-esteem. In addition, depression on TI could be explained mainly by personality-related aspects rather than functional status and tenderness. This pattern was also present in explaining the variance of T2 depression. However, in this latter regression analysis functional status did not contribute to depression. From the results it can be concluded that factors related to the disease process such as activity restrictions and tenderness, are not or only slightly related to the psychological status of RA patients. In addition, personality characteristics, especially the level of self-esteem, appeared to be an important determinant of depressive mood in patients with RA. These findings may contribute to the treatment of RA patients by explicitly paying attention to the relevance of personality-related aspects in (self-) management programmes.