Depression, illness perception and coping in rheumatoid arthritis.
ABSTRACT This study aimed to establish the relationship between depression, illness perception, coping strategies, and adverse childhood events in rheumatoid arthritis patients. Sixty-two out-patients with rheumatoid arthritis (RA) completed the Hospital Anxiety and Depression Scale, Illness Perception Questionnaire, London Coping with Rheumatoid Arthritis Questionnaire, and Childhood Development Questionnaire, and underwent a clinical assessment of their physical state. Depressed patients were more disabled than the nondepressed, had a more negative view of their illness, and used more negative coping strategies. There was no association between depression and childhood adversity. Once disability was controlled for, there continued to be a significant correlation between depression and: (i) viewing the consequences of the illness negatively (Spearman's correlation coefficient [r]=0.37, p=0.003); and (ii) the perceived ability to control the illness (r= -0.26, p=0.04). The relationship between depression and negative coping strategies became insignificant. This study indicates the close relationship between depression and a negative view of the illness.
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ABSTRACT: Aim. Rheumatoid arthritis is one of the most severe chronic diseases. In many cases it leads to disability and results in a decreased quality of life and increased levels of anxiety and depression. The problem that needs to be addressed is the following: which mental processes lead to increased levels of depression in patients with rheumatoid arthritis? Methods. 210 patients with rheumatoid arthritis hospitalized in rheumatology wards took part in the research. They filled in illness perception questionnaires (IPQ-R) and questionnaires for testing strategies of handling stress (Mini-COPE) and the level of depression (CES-D). Results. The observed correlation coefficients indicate that several elements of the perception of one's disease moderately contribute to a high level of depression. Moreover, frequent use of dysfunctional coping strategies contributed to high levels of depression. Dysfunctional coping was moderately linked to depression. Conclusion. The conducted analyses confirmed the links between the beliefs about the disease and levels of depression and showed that the use of dysfunctional coping strategies mediates the relationship between the following elements of the representation of the disease: illness coherence, emotional representation, psychological attribution, risk factors, and the level of depression.The Scientific World Journal 01/2014; 2014:585063. · 1.22 Impact Factor
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ABSTRACT: Objective: The DAS28, used to assess disease activity in rheumatoid arthritis (RA), is a composite score comprising clinical, biochemical and patient self-report measures. We hypothesized that psychological factors (cognitions and mood) would be more strongly associated with patient reported components of DAS28 than clinical or biochemical components. Methods: A cross-sectional, observational study of 322 RA patients awaiting biologic therapy with active disease (mean DAS28 = 6.0) was undertaken. Patients’ illness beliefs, treatment beliefs and mood were measured using the Brief Illness Perception Questionnaire (Brief IPQ), the Beliefs about Medicines Questionnaire (BMQ) and the Hospital Anxiety and Depression Scale, respectively. Relationships between psychological factors and (i) total DAS28 (ii) individual components of DAS28 were analysed using linear regression. Results: Total DAS28 produced significant but weak associations with two of the Brief IPQ items but no associations with BMQ or HADS scores. There were larger significant associations between the patient reported visual analogue scale (VAS) with five items of the Brief IPQ and with HADS depression. Low illness coherence was associated with higher tender joint count. Three Brief IPQ items and HADS anxiety scores were significantly associated with C-reactive protein or erythrocyte sedimentation rate. No psychological factors were associated with the swollen-joint count. Conclusion: One of the subjective components of the DAS28, patient VAS, was highly correlated with cognitive factors and depression in those with severe RA. By reporting individual DAS28 components, clinicians may be better able to assess the impact of therapies on each component, adjusting approaches according to patients’ needs. © 2013 American College of Rheumatology.Arthritis Care & Research. 11/2013;
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ABSTRACT: Raising a child with an autism spectrum disorder (ASD) is a severe stressor and parents often present high levels of depression. Depression is associated with illness perceptions but this association has not been studied in parents of ASD offspring. We aimed to assess the prevalence of psychological distress symptoms and their associations with illness perceptions in parents with an ASD offspring. In 111 parents of ASD offspring we assessed depressive symptoms (PHQ-9), illness perceptions (B-IPQ) and general psychological distress (GHQ-28). Multiple linear and logistic regressions were used to assess their independent associations. The prevalence of parental clinically significant depressive symptoms was 34.2%, while 55% presented clinically significant levels of general psychological distress. Younger parents and those with lower financial resources had greater psychological distress and more severe depressive symptoms. Parents felt that the condition impacted their lives and believed it would be chronic. Their beliefs about the consequences and the chronicity of the disorder were significant independent correlates of their psychological distress and depressive symptoms severity. These findings indicate that a remarkable proportion of parents with an ASD offspring present clinically significant depressive symptoms, which were associated with illness perceptions relevant to the consequences and the chronicity of the disorder. Our data encourage psychotherapeutic interventions aiming to support parents to deal with the consequences and chronicity of their offspring's disorder, in order to reduce parental psychological distress.Disability and Health Journal 04/2014; 7(2):173-80. · 1.50 Impact Factor