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Stressors and rheumatoid arthritis: changes in stressors with advances in therapeutic agents

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Abstract

The significance of evaluations of stressors in rheumatoid arthritis (RA) patients was investigated from the perspective of holistic medicine. The subjects were RA patients treated in the rheumatology outpatient clinic. They included 30 patients from 1987, 30 from 2002, and 137 from 2009. To investigate the specific causes of stress, the patients were asked the question, “What do you feel is your strongest stressor?” The same patients also underwent psychological testing and was examined the disease activity. Pain was the strongest stressor in RA patients in 1987, 2002, and 2009. However, the percentage of patients citing pain as their major stressor was decreasing with each year. CRP was significantly lower in 2009 than in 2002. CRP was also significantly lower in patients who used biologics than in patients who did not. In 2009, DAS28-CRP was significantly higher in patients whose largest stressor was pain than in patients whose largest stressor was another factor. In 2009, the values for both state anxiety and trait anxiety were significantly higher in patients who said that they had stressors than in those who said they did not. The strongest stressor in RA patients was pain. However, the percentage decreased over the years with lower disease activity from advances in therapeutic agents such as biologics. Meanwhile, stressors other than pain were the same or somewhat increased, and they were related to anxiety or depression. Understanding stressors in RA is thus important in treating RA patients.

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References

  1. Alexander F (1950) Psychosomaic Medicine. WW. Norton and Company, New York, pp 104–106

    Google Scholar 

  2. Malysheva O, Pierer M et al (2010) Stress and rheumatoid arthritis. Z Rheumatol 69:539–543

    Article  PubMed  CAS  Google Scholar 

  3. Suurmeijer TP, Waltz T et al (2001) Quality of life profiles in the first year of rheumatoid arthritis. Arthritis Rheum 45:111–121

    Article  PubMed  CAS  Google Scholar 

  4. Stojanovich L, Marisavljevich D et al (2008) Stress as a trigger of autoimmune disease. Autoimmun Rev 7:209–213

    Article  PubMed  Google Scholar 

  5. Mahat G (1997) Perceived stressor and coping strategies among individuals with rheumatoid arthritis. J Adv Nurs 25:1144–1150

    Article  PubMed  CAS  Google Scholar 

  6. Meenan RF, Gertman PM et al (1980) Measuring health status in arthritis: the arthritis impact measurement scales. Arthritis Rheum 23:146–152

    Article  PubMed  CAS  Google Scholar 

  7. Meenan RF, Mason JH et al (1992) AIMS2: the content and properties of a revised and expanded arthritis impact measurement scales health status questionnaire. Arthritis Rheum 35:1–10

    Article  PubMed  CAS  Google Scholar 

  8. American Psychiatric Association (1980) Quick reference to the diagnostic criteria from DSM-III. American Psychiatric Publishing, Washington, DC

  9. American Psychiatric Association (1994) Quick reference to the diagnostic criteria from DSM-IV. American Psychiatric Publishing, Washington, DC

  10. Prevoo ML, Van t Hof MA et al (1995) Modified disease activity score that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48

    Article  PubMed  CAS  Google Scholar 

  11. Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press, Palo Alto

    Google Scholar 

  12. Zung WWK (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70

    Article  PubMed  CAS  Google Scholar 

  13. Van Lankveld W, Naring G et al (1993) Stress caused by rheumatoid arthritis: relation among subjective stressor of the disease, disease status and well-being. J Behav Med 16:309–321

    Article  PubMed  Google Scholar 

  14. Maini RN, Breedveld FC et al (2004) Sustained improvement over 2 years in physical function, structural damage, and signs and symptoms among patients with rheumatoid arthritis treated with infliximab and methotrexate. Arthritis Rheum 50:1051–1065

    Article  PubMed  CAS  Google Scholar 

  15. Goekoop-Ruiterman YPM, De Vries-Bouwstra JK et al (2005) Clinical and radiographic outcome of four different treatment strategies in patients with early rheumatoid arthritis (the Best study). Arthritis Rheum 52:3381–3390

    Article  PubMed  CAS  Google Scholar 

  16. Yocum D, Rahman MV et al (2004) Infliximab rapidly improves all components of physical function assessed by the HAQ in patients with rheumatoid arthritis. Arthritis Rheum 50:118–122

    Article  Google Scholar 

  17. Russell AS (2008) Quality-of-life assessment in rheumatoid arthritis. Pharmacoeconomics 26:831–846

    Article  PubMed  CAS  Google Scholar 

  18. Odegard S, Finset A et al (2007) Pain and psychological health status over a 10-year period in patients with recent onset rheumatoid arthritis. Ann Rheum Dis 66:1195–1201

    Article  PubMed  Google Scholar 

  19. Zeitlin DJ (1977) Psychological issues in the management of rheumatoid arthritis. Psychosomatics 18:7–14

    PubMed  CAS  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Tomoko Otake, Jo Nishino, Kenichi Kato, Shusaku Fukaya & Shunji Yoshida

  2. Chubu Rosai Hospital, Nagoya, Aichi, Japan

    Mutsumi Ashihara

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  1. Tomoko Otake
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  2. Mutsumi Ashihara
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  3. Jo Nishino
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  4. Kenichi Kato
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  5. Shusaku Fukaya
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  6. Shunji Yoshida
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Correspondence to Tomoko Otake.

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Otake, T., Ashihara, M., Nishino, J. et al. Stressors and rheumatoid arthritis: changes in stressors with advances in therapeutic agents. Rheumatol Int 33, 887–891 (2013). https://doi.org/10.1007/s00296-012-2457-6

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  • DOI: https://doi.org/10.1007/s00296-012-2457-6

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