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Psychosocial problems among newly diagnosed rheumatoid arthritis patients

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Abstract

We identified patients with newly diagnosed rheumatoid arthritis (RA) in the ages 18–65 years who needed psychosocial interventions. A total of 123 patients (90 women) were asked to participate, but 19 declined and 4 dropped out early in the study, leaving a total of 100 patients (75 women) in the sample. Questionnaires used were the Epidemiological Investigation on Rheumatoid Arthritis study questionnaire, the Hospital Anxiety and Depression Scale, the Sense of Coherence (SOC) scale, and the General Coping Questionnaire. Interviews showed that 46% of the included 100 patients had psychosocial problems (PSP). One third of them had problems directly related to RA. The rest had problems with their life situation in general, without or reinforced by RA. Compared to patients without psychosocial problems, PSP patients lived in more strained social situations, especially regarding personal finances and social support. More of the PSP patients were anxious, showed lower SOC scores, and also used more emotion-based coping strategies (resignation, protest, isolation and intrusion) and less problem-oriented (minimization). They also had higher scores on depression and more frequently expected that RA would negatively affect their future. PSP patients also experienced a more negative impact of the disease, a finding not confirmed by the sickness activity score judged by the rheumatologist. Thus, early in the course of RA, screening instruments should be used to identify PSP patients. Psychosocial treatment and support by medical social workers skilled in RA care should be offered.

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acknowledgments

This study was supported by grants from the Swedish Rheumatism Association and the Norrbacka-Eugenia Foundation. Special thanks to Professor Lars Klareskog at the Department of Rheumatology at Karolinska University Hospital and Professor Lars Alfredsson at the Institute of Environmental Medicine Karolinska Institutet for access to important data from the EIRA study. Special thanks also to Scientific Editors Kimberly Kane and Stella Papadopoulou at the Center for Family and Community Medicine and M Sci Maria Flink at the Department of Social Work, Karolinska University Hospital for their valuable assistance.

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Authors and Affiliations

  1. Department of Social Work, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden

    C. Gåfvels & M. Hägerström

  2. Center for Family and Community Medicine, Karolinska Institutet, Alfred Nobels allé 12, 141 83, Huddinge, Sweden

    C. Gåfvels & P. E. Wändell

  3. Department of Rheumatology, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden

    M. Hägerström & B. Nordmark

Authors
  1. C. Gåfvels
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  2. M. Hägerström
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  3. B. Nordmark
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  4. P. E. Wändell
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Correspondence to P. E. Wändell.

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Gåfvels, C., Hägerström, M., Nordmark, B. et al. Psychosocial problems among newly diagnosed rheumatoid arthritis patients. Clin Rheumatol 31, 521–529 (2012). https://doi.org/10.1007/s10067-011-1894-z

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  • DOI: https://doi.org/10.1007/s10067-011-1894-z

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