Skip to main content

Advertisement

SpringerLink
Log in

The relationship between disease activity, quality of life, and personality types in rheumatoid arthritis and ankylosing spondylitis patients

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

We hypothesized that clinical outcomes might be influenced by personality type (A, B, C, D) in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). One hundred ninety-four patients (104 with RA, 90 with AS) participated in a questionnaire study. We evaluated health-related quality of life (HRQoL) using the Medical Outcome Study Short-Form 36 (SF-36), personality type A/B with the Jenkins Activity Survey, type C with the State-Trait Anger Expression Inventory Anger-in Scale, type D with the Type D Personality Scale, and disease activity with Disease Activity Score with 28 joints for RA and Bath Ankylosing Spondylitis Disease Activity Index for AS. We used Pearson’s correlation coefficient, independent samples t tests, and multivariate analyses of variance. In the RA group, type D personality was significantly correlated with 7/12 SF-36 components. AS patients with type D personality had deficits in all SF-36 subscales. Type D was related with higher disease activity in RA and AS. Both RA and AS type C patients had more active disease forms and negatively affected HRQoL subscales. In the RA group, type A personality did not correlate with HRQoL, but it positively influenced pain visual analog scale scores. In AS patients, type A personality was linked with higher HRQoL and with less active disease. Type C and type D personality types were correlated with decreased HRQoL and higher disease activity in RA and AS patients. Type A personality was associated with less active disease and higher HRQoL in AS patients and with less pain in RA patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Spoorenberg A, van Tubergen A, Landewe R, Dougados M, van der Linden S, Mielants H, van de Tempel H, van der Heijde D (2005) Measuring disease activity in ankylosing spondylitis: patient and physician have different perspectives. Rheumatology (Oxford) 44(6):789–795. doi:10.1093/rheumatology/keh595

    Article  CAS  Google Scholar 

  2. Khanna D, Krishnan E, Dewitt EM, Khanna PP, Spiegel B, Hays RD (2011) The future of measuring patient-reported outcomes in rheumatology: patient-reported outcomes measurement information system (PROMIS). Arthritis Care Res (Hoboken) 63(11):S486–S490. doi:10.1002/acr.20581

    Article  Google Scholar 

  3. Klaassen K, Nyklíček I, Traa S, de Nijs R (2012) Distressed personality is associated with lower psychological well-being and life satisfaction, but not disability or disease activity in rheumatoid arthritis patients. Clin Rheumatol 31(4):661–667. doi:10.1007/s10067-011-1905-0

    Article  PubMed  Google Scholar 

  4. Sanderman R, Ranchor AV (1997) The predictor status of personality variables: etiological significance and their role in the course of disease. Eur J Pers 11(5):359–382. doi:10.1002/(SICI)1099-0984(199712)11:5<359::AID-PER307>3.0.CO;2-0

    Article  Google Scholar 

  5. Hausteiner C, Klupsch D, Emeny R, Baumert J, Ladwig K-H (2010) Clustering of negative affectivity and social inhibition in the community: prevalence of type D personality as a cardiovascular risk marker. Psychosom Med 72(2):163–171. doi:10.1097/PSY.0b013e3181cb8bae

    Article  PubMed  Google Scholar 

  6. Dalton SO, Boesen EH, Ross L, Schapiro IR, Johansen C (2002) Mind and cancer: do psychological factors cause cancer? Eur J Cancer 38(10):1313–1323. doi:10.1016/S0959-8049(02)00099-0

    Article  CAS  PubMed  Google Scholar 

  7. Hagglund KJ, Haley WE, Reveille JD, Alarcon GS (1989) Predicting individual differences in pain and functional impairment among patients with rheumatoid arthritis. Arthritis Rheum 32(7):851–858

    CAS  PubMed  Google Scholar 

  8. Watson D, Pennebaker JW (1989) Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychol Rev 96(2):234–254

    Article  CAS  PubMed  Google Scholar 

  9. Mols F, Denollet J (2010) Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems. Health Qual Life Outcomes 8:9. doi:10.1186/1477-7525-8-9

    Article  PubMed  PubMed Central  Google Scholar 

  10. Spindler H, Larsen ML, Pedersen SS (2006) Type-D personality is associated with impaired health status in chronic heart failure patients. J Psychosom Res 61(3):404

    Google Scholar 

  11. de Brouwer SJ, Kraaimaat FW, Sweep FC, Creemers MC, Radstake TR, van Laarhoven AI, van Riel PL, Evers AW (2010) Experimental stress in inflammatory rheumatic diseases: a review of psychophysiological stress responses. Arthritis Res Ther 12(3):R89. doi:10.1186/ar3016

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sun J, Wang S, Zhang JQ, Li W (2007) Assessing the cumulative effects of stress: the association between job stress and allostatic load in a large sample of Chinese employees. Work Stress 21(4):333–347. doi:10.1080/02678370701742748

    Article  Google Scholar 

  13. Oswald LM, Zandi P, Nestadt G, Potash JB, Kalaydjian AE, Wand GS (2006) Relationship between cortisol responses to stress and personality. Neuropsychopharmacology 31(7):1583–1591. doi:10.1038/sj.npp.1301012

    Article  CAS  PubMed  Google Scholar 

  14. Tyrka AR, Wier LM, Price LH, Rikhye K, Ross NS, Anderson GM, Wilkinson CW, Carpenter LL (2008) Cortisol and ACTH responses to the Dex/CRH test: influence of temperament. Horm Behav 53(4):518–525. doi:10.1016/j.yhbeh.2007.12.004

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  16. Linde L, Sørensen J, Østergaard M, Hørslev-Petersen K, Hetland ML (2008) Health-related quality of life: validity reliability, and responsiveness of SF-36, EQ-15D, EQ-5D, RAQoL, and HAQ in patients with rheumatoid arthritis. J Rheumatol 35(8):1528–1537

    PubMed  Google Scholar 

  17. Ward MM (1999) Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res 12(4):247–255. doi:10.1002/1529-0131(199908)12:4<247::AID-ART3>3.0.CO;2-H

    Article  CAS  PubMed  Google Scholar 

  18. Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23(2):137–145. doi:10.1002/art.1780230202

    Article  CAS  PubMed  Google Scholar 

  19. Meenan RF, Gertman PM, Mason JH (1980) Measuring health status in arthritis. The arthritis impact measurement scales. Arthritis Rheum 23(2):146–152. doi:10.1002/art.1780230203

    Article  CAS  PubMed  Google Scholar 

  20. Davis JC Jr, Revicki D, van der Heijde DM, Rentz AM, Wong RL, Kupper H, Luo MP (2007) Health-related quality of life outcomes in patients with active ankylosing spondylitis treated with adalimumab: results from a randomized controlled study. Arthritis Rheum 57(6):1050–1057. doi:10.1002/art.22887

    Article  PubMed  Google Scholar 

  21. Frendl DM, Ware JE Jr (2014) Patient-reported functional health and well-being outcomes with drug therapy: a systematic review of randomized trials using the SF-36 health survey. Med Care 52(5):439–445. doi:10.1097/MLR.000000000000010311

    Article  PubMed  Google Scholar 

  22. Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305(6846):160–164. doi:10.1136/bmj.305.6846.160

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Yarnold PR, Bryant FB, Grimm LG (1987) Comparing the long and short forms of the student version of the Jenkins activity survey. J Behav Med 10(1):75–90. doi:10.1007/BF00845129

    Article  CAS  PubMed  Google Scholar 

  24. Spielberger CD (2010) State-trait anger expression inventory. In: The Corsini encyclopedia of psychology John Wiley & Sons. doi:10.1002/9780470479216.corpsy0942

    Google Scholar 

  25. Denollet JK (2002) Type D personality and vulnerability to chronic disease, impaired quality of life, and depressive-symptoms. Psychosom Med 64:101

    Google Scholar 

  26. Fransen J, Stucki G, van Riel PLCM (2003) Rheumatoid arthritis measures: disease activity score (DAS), disease activity score-28 (DAS28), rapid assessment of disease activity in rheumatology (RADAR), and rheumatoid arthritis disease activity index (RADAI). Arthritis Care Res 49(S5):S214–S224. doi:10.1002/art.11407

    Article  Google Scholar 

  27. van der Heijde DM, van 't Hof M, van Riel PL, van de Putte LB (1993) Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol 20 (3):579–581

  28. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291

    CAS  PubMed  Google Scholar 

  29. Kvien TK, Uhlig T, Odegard S, Heiberg MS (2006) Epidemiological aspects of rheumatoid arthritis: the sex ratio. Ann N Y Acad Sci 1069:212–222. doi:10.1196/annals.1351.019

    Article  PubMed  Google Scholar 

  30. Lee W, Reveille JD, Davis JC Jr, Learch TJ, Ward MM, Weisman MH (2007) Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis 66(5):633–638. doi:10.1136/ard.2006.060293

    Article  PubMed  Google Scholar 

  31. Kvien TK (2004) Epidemiology and burden of illness of rheumatoid arthritis. PharmacoEconomics 22(1):1–12. doi:10.2165/00019053-200422001-00002

    Article  PubMed  Google Scholar 

  32. Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A (2002) Ankylosing spondylitis: an overview. Ann Rheum Dis 61(3):8–18. doi:10.1136/ard.61.suppl_3.iii8

    Article  Google Scholar 

  33. Denollet J, Vaes J, Brutsaert DL (2000) Inadequate response to treatment in coronary heart disease: adverse effects of type D personality and younger age on 5-year prognosis and quality of life. Circulation 102(6):630–635. doi:10.1161/01.cir.102.6.630

    Article  CAS  PubMed  Google Scholar 

  34. Stevenson C, Williams L (2014) Type D personality, quality of life and physical symptoms in the general population: a dimensional analysis. Psychol Health 29(3):365–373. doi:10.1080/08870446.2013.856433

    Article  PubMed  Google Scholar 

  35. Erkol Inal E, Demirci K, Dogru A, Sahin M (2016) Ankylosing spondylitis patients with type D personality have worse clinical status. Mod Rheumatol 26(1):138–145. doi:10.3109/14397595.2015.1054098

    Article  CAS  PubMed  Google Scholar 

  36. Tan G, Jensen MP, Thornby J, Sloan PA (2008) Negative emotions, pain, and functioning. Psychol Serv 5(1):26–35

    Article  Google Scholar 

  37. Carson JW, Keefe FJ, Lowry KP, Porter LS, Goli V, Fras AM (2007) Conflict about expressing emotions and chronic low back pain: associations with pain and anger. J Pain 8(5):405–411. doi:10.1016/j.jpain.2006.11.004

    Article  PubMed  Google Scholar 

  38. Mattila AK, Saarni SI, Salminen JK, Huhtala H, Sintonen H, Joukamaa M (2009) Alexithymia and health-related quality of life in a general population. Psychosomatics 50(1):59–68. doi:10.1176/appi.psy.50.1.59

    Article  PubMed  Google Scholar 

  39. Julkunen J, Ahlström R (2006) Hostility, anger, and sense of coherence as predictors of health-related quality of life. Results of an ASCOT substudy. J Psychosom Res 61(1):33–39. doi:10.1016/j.jpsychores.2005.12.005

    Article  PubMed  Google Scholar 

  40. Kaprara A, Pazaitou-Panayiotou K, Kortsaris A, Chatzaki E (2010) The corticotropin releasing factor system in cancer: expression and pathophysiological implications. Cell Mol Life Sci 67(8):1293–1306. doi:10.1007/s00018-010-0265-2

    Article  CAS  PubMed  Google Scholar 

  41. Lim HJ, Moon YI, Lee MS (2005) Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis. Rheumatol Int 25(3):225–229. doi:10.1007/s00296-004-0536-z

    Article  PubMed  Google Scholar 

  42. Chorus AM, Miedema HS, Boonen A, Van Der Linden S (2003) Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis 62(12):1178–1184. doi:10.1136/ard.2002.004861

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Pittner MS, Houston BK (1980) Response to stress, cognitive coping strategies, and the type A behavior pattern. J Pers Soc Psychol 39(1):147–157. doi:10.1037/0022-3514.39.1.147

    Article  CAS  PubMed  Google Scholar 

  44. Terracciano A, Costa PT Jr, McCrae RR (2006) Personality plasticity after age 30. Personal Soc Psychol Bull 32(8):999–1009. doi:10.1177/0146167206288599

    Article  Google Scholar 

  45. Sutin AR, Costa PT Jr, Wethington E, Eaton W (2010) Turning points and lessons learned: stressful life events and personality trait development across middle adulthood. Psychol Aging 25(3):524–533. doi:10.1037/a0018751

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Rheumatology “Sf. Maria” Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania

    T. Donisan, V. C. Bojincă, M. A. Dobrin, D. Predețeanu, F. Berghea, D. Opriș, L. Groșeanu, A. Borangiu, C. L. Constantinescu, R. Ionescu & A. R. Bălănescu

  2. “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania

    T. Donisan, V. C. Bojincă, D. V. Bălănescu, D. Predețeanu, M. Bojincă, F. Berghea, D. Opriș, L. Groșeanu, A. Borangiu, C. L. Constantinescu, R. Ionescu & A. R. Bălănescu

  3. Department of Internal Medicine and Rheumatology “Dr. I. Cantacuzino” Hospital, 5-7 Ion Movilă Str, Bucharest, Romania

    M. Bojincă

Authors
  1. T. Donisan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. C. Bojincă
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. A. Dobrin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. V. Bălănescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Predețeanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Bojincă
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F. Berghea
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. Opriș
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. L. Groșeanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A. Borangiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C. L. Constantinescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. R. Ionescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. A. R. Bălănescu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. C. Bojincă.

Ethics declarations

Disclosures

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Donisan, T., Bojincă, V.C., Dobrin, M.A. et al. The relationship between disease activity, quality of life, and personality types in rheumatoid arthritis and ankylosing spondylitis patients. Clin Rheumatol 36, 1511–1519 (2017). https://doi.org/10.1007/s10067-017-3654-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-017-3654-1

Keywords

Search

Navigation