Psychological disorders in rheumatoid arthritis: a growing consensus?

Article Abstract:

Rheumatoid arthritis (RA) is an inflammatory disease which has an autoimmune component, in which the body makes antibodies against its own tissues. Its cause is unknown. For many years, researchers speculated on the role of psychology in RA, and many discussed the existence of a ''rheumatoid personality'' and the role of psychological stress in promoting the disease. Although most personality and relationship difficulties are generally thought of now as the result rather than the cause of chronic disabling diseases, a recent report suggested that stress may play a causative role. Earlier studies contained many methodological problems, but more recent research has used improved techniques. These recent studies are reviewed in a discussion of the role of psychological disorders in RA. These studies have characterized the underlying personality, current mental state, and current social stresses. Social stress has been infrequently studied in arthritic patients. A full range of personalities is represented early in the course of RA, some of which adapt well, while others that are prone to anxiety react poorly to increasing disability. The prevalence of depression was about 20 percent, a level similar to that found with other chronic diseases. The presence of depression was associated with a lack of social support and experience of social stress rather than extent of disability. For example, stress such as marital problems may lead to depression unless there is good support from the surrounding social contacts. However, such support is less likely to be available as the degree of disability increases. Patients who were anxious or depressed attended the clinic significantly more frequently, but this was unrelated to the degree of arthritis. Such patients are more likely to experience and complain about more pain, and to be excessively concerned about the disease. It is suggested that appropriate treatment of RA include recognition and treatment, either psychological or pharmacological, of anxiety and depression. However, because such patients are likely lacking in social support and subject to social stress, those areas may need attention. These areas should become a routine part of rheumatological care, and patient global function should subsequently improve. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Rheumatoid arthritis, Psychological manifestations of general diseases, Psychological symptoms

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Serum interleukin 12 concentration in juvenile chronic arthritis

Article Abstract:

Elevated blood levels of interleukin 12 could activate the immune system and produce juvenile chronic arthritis (JCA). Interleukin 12 is an immune system protein that activates helper T cells. Researchers measured the level of interleukin 12 as well as its heavy chain and light chain in blood samples from 50 patients with JCA and 20 healthy volunteers. Total interleukin 12 levels were higher in the patients with active JCA than in the healthy volunteers and the JCA patients who were in remission. However, further analysis revealed this was mostly light chain. Levels peaked early in the disease and then dropped.

Measurement, Physiological aspects, Interleukins

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Psychological, behavioural, and social adjustment in children and adolescents with juvenile chronic arthritis

Article Abstract:

Many children with juvenile chronic arthritis are remarkable well-adjusted and able to cope with their disease. This is partly due to a strong family and other sources of support.

Children

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