Rheumatoid arthritis, personality, stress response style, and coping with illness. A preliminary survey

Ann N Y Acad Sci. 1999 Jun 22:876:419-25. doi: 10.1111/j.1749-6632.1999.tb07666.x.

Abstract

Rheumatoid arthritis (RA) is an inflammatory chronic disease with an autoimmune pathogenesis and a complex multifactorial etiology. Various factors such as immunogenetic determinants, sex, age, and stress play an important role. The relationship between stress and RA is still unclear and undefined; however, various lines of research are developing in order to evaluate environmental, psychologic, and biologic stressors as predisposing factors. The aim of our study was to evaluate whether stress-related psychologic factors and personality disorders might be involved in the development of RA, by using a psychometric investigation-methodology in a series of patients. Fifteen in- and outpatients underwent a clinical interview and other specific psychometric tests. Macro- and microstressful life-events preceded RA onset in 86% of the cases. Sixty percent of the patients showed a correlation between flare-ups of the disease and appearance of microevents. Forty percent of the patients showed an obsessive-compulsive personality disorder (OCPD), 40% showed a borderline personality disorder (BPD), 7% showed a schizoid and a dependent disorder. Only 13% of the patients showed no personality disorders. Among the BPD group we also detected alexithymia. Our results should be considered as preliminary; on the other hand, the high prevalence of major life-events preceding the onset of RA and the presence of personality disorders support the role of the altered stress response system as an important pathogenetic factor and will be a matter of further studies.

MeSH terms

  • Adaptation, Psychological / physiology*
  • Adult
  • Aged
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / psychology*
  • Attitude
  • Borderline Personality Disorder / complications
  • Borderline Personality Disorder / psychology
  • Compulsive Personality Disorder / complications
  • Compulsive Personality Disorder / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Personality / physiology*
  • Stress, Psychological / complications
  • Stress, Psychological / physiopathology*
  • Stress, Psychological / psychology*