Treharne GJ, Kitas GD, Lyons AC, Booth DA. Well being in rheumatoid arthritis: the effects of disease duration and psychosocial factors
ABSTRACT This study examined the multivariate relationships of psychosocial factors with well-being in rheumatoid arthritis (RA). Fifty-five patients with early RA (<six months), 52 with intermediate RA (one-seven years) and 47 with established RA (>seven years) completed questionnaires on psychosocial factors and psychological and physical well-being. Illness perceptions related to worse depression and life satisfaction (especially in early RA) and to longer morning stiffness (especially in intermediate RA). Optimism related to lower pain in early and intermediate RA. Social support related to lower fatigue in established RA. Indications for interventions targeted by disease duration are discussed.
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- "It is a significant predictor of physical health  and is associated with enhanced physical recovery in a number of conditions and procedures such as traumatic brain injury, lung cancer, breast cancer, and bone marrow transplant . The protective effects of optimism also extend to both pain and physical symptom reporting, and negative associations between optimism and pain have been reported in a number of chronic illnesses    . Post-operative pain reporting is also lower among patients higher in optimism and this association has been demonstrated in patients who have undergone breast cancer surgery , and knee surgery  . "
ABSTRACT: Objective Optimism is thought to be associated with long-term favourable outcomes for patients undergoing coronary artery bypass graft (CABG) surgery. Our objective was to examine the association between optimism and post-operative pain and physical symptoms in CABG patients. Methods We assessed optimism pre-operatively in 197 adults undergoing CABG surgery, and then followed them up 6-8 weeks after the procedure to measure affective pain, pain intensity, and physical symptom reporting directly pertaining to CABG surgery. Results Greater optimism measured pre-operatively was significantly associated with lower pain intensity (β = -0.150, CI = -0.196 - -0.004, p = .042) and fewer physical symptoms following surgery (β = -0.287, CI = -0.537 - -0.036, p = .025), but not with affective pain, after controlling for demographic, clinical and behavioural covariates, including negative affectivity. Conclusions Optimism is a modest, yet significant, predictor of pain intensity and physical symptom reporting after CABG surgery. Having positive expectations may promote better recovery.Journal of Psychosomatic Research 10/2014; 77(4). DOI:10.1016/j.jpsychores.2014.07.018 · 2.74 Impact Factor
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- "These problems are often associated with depression and functional status (Morris et al. 2008), with difficulties at work appearing even at early phases (Geuskens et al. 2007). The risk of depression is higher in early stages of RA (Treharne et al. 2005), and findings in a review article do suggest that psychological interventions may be more effective for patients with a shorter duration of the disease (Astin et al. 2002). Low social support is considered a predictor of depression and anxiety in people with RA (Zyrianova et al. 2006), and high social support might weaken the effects of distress, at least in people at an early stage of RA (Strating et al. 2006). "
ABSTRACT: We aimed at analyzing important predictive factors for experienced negative emotional and social effects of rheumatoid arthritis (RA) two years after diagnosis in patients aged 18–65 years. The first group included 41 participants, who had psychosocial problems (PSP) already at diagnosis, and who received an intervention by a medical social worker to improve coping capacity and social situation. The second group included 54 patients (NPSP) without such problems at diagnosis. All completed a questionnaire mapping their social situation, the Hospital Anxiety and Depression Scale (HADS), the Sense of Coherence Scale (SOC) and the General Coping Questionnaire (GCQ) at diagnosis and after 24 months. The most pronounced predictive factor for a strong impact of the disease was high scores on HADS depression scale. After 24 months, PSP participants had a more strained life situation, with higher scores on anxiety and depression and lower on SOC, in comparison with NPSP. NPSP participants improved their coping strategies regarding self-trust, cognitive revaluation, protest and intrusion, but deteriorated regarding problem focusing and social trust. PSP patients kept their initial coping strategies, except for intrusion decreasing over time, and seemed to have a more rigid coping pattern. However, the experienced negative impact of the disease increased over time in both groups despite improvement in sickness related data. Mostly influenced areas were economy, leisure time activities and social life. We conclude that psychosocial consequences of RA are more connected to emotional and social vulnerability than are RA-related clinical factors. Electronic supplementary material The online version of this article (doi:10.1186/2193-1801-3-118) contains supplementary material, which is available to authorized users.SpringerPlus 02/2014; 3(1):118. DOI:10.1186/2193-1801-3-118
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- "Previous studies in RA patients have shown individual illness perceptions to be related to psychological and physical well-being (Carlisle et al., 2005; Graves et al., 2009; Groarke, Curtis, Coughlan, & Gsel, 2005; Murphy, Dickens, Creed, & Bernstein, 1999; Scharloo et al., 1999; Sharpe et al., 2001; Treharne et al., 2005; Treharne, Lyons, Booth, & Kitas, 2007), findings that were replicated in the current analysis as many illness perceptions correlated Illness representation of RA 15 significantly with outcomes. Two studies in other chronic physical conditions have identified groups that have been termed "adapters" and "non-adapters" using cluster analytic methods (Hobro et al., 2004; Miglioretti et al., 2008). "
ABSTRACT: This study extends previous work to consider whether individuals with rheumatoid arthritis (RA) can be categorised into groups with similar illness representations. Data from 227 RA patients attending outpatient clinics were collected prospectively at two time points, 6 months apart. The optimal number of illness representation groups at the baseline assessment was identified using latent profile analysis. Two groups of individuals sharing similar illness perception profiles were identified. The smaller group (43 %), characterised by a negative representation of their illness, attributed more symptoms to their condition and reported stronger perceptions of the consequences, chronicity and cyclicality of their condition, and lower control compared to the positive representation group (57 %). Cross-sectionally, membership of the negative representation group was associated with higher levels of pain and functional disability and, longitudinally, with increases in levels of pain, functional disability and distress. These data highlight the central role of illness perceptions in RA and suggest that individuals with RA can be categorised into groups with similar illness representations.Journal of Behavioral Medicine 03/2013; 37(3). DOI:10.1007/s10865-013-9506-9 · 3.10 Impact Factor