Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways

Individuals with rheumatoid arthritis (RA) demonstrate an increased prevalence of mood disorders compared with the general population, but a decreased prevalence of schizophrenia, probably due to alterations in inflammatory processesSeveral mechanisms underlie the relationship between RA and mental health comorbidities: cognitive, behavioural and affective responses, inflammatory processes, and fatigueSocial factors have important implications in psychological reactions to RA, and could also be involved in pain processing and RA disease activityNeural reward-processing deficiencies are an emerging area of inquiry in understanding the relationship between pain and psychological states that warrants additional attention in patients with RAPsychological treatments that increase active coping strategies, ameliorate affective distress, bolster self-efficacy, and increase supportive social relationships could improve treatment outcomes in patients with RA