title: Determinants of psychological distress and its course in the first year after diagnosis in rheumatoid arthritis patients.
abstract: In order to examine determinants of psychological distress and its course in the first year after diagnosis in rheumatoid arthritis patients, self-report data and clinical and laboratory measures were collected in 91 patients (70% female, mean age 57 years) shortly after diagnosis and 1 year later. Multiple regression analysis indicated that sex, pain and functional status, disease impact on daily life, life events, and perceived social support were related to psychological distress (anxiety and depressed mood) shortly after diagnosis. Coping strategies were related to distress levels only 1 year later. Multiple regression analysis of change in anxiety and depressed mood revealed that a decrease of psychological distress after 1 year could be predicted by male sex, an initially less severe inflammatory activity and an initially more extended social network. In addition, a decrease in distress was related to parallel improvements in clinical status. Results indicate the importance of a multimodal assessment of demographic variables, clinical and life stressors and social resources for the understanding of distress and the identification of risk factors in the first stage of the disease. Personal coping resources appear to become more important predictors of distress in a later phase of the disease.
authors.affiliation: Department of Medical Psychology, University Hospital Nijmegen, The Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: Evers
authors.forename: F W
authors.initials: FW
authors.lastname: Kraaimaat
authors.forename: R
authors.initials: R
authors.lastname: Geenen
authors.forename: J W
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology