Rheumatoid arthritis, personality, stress response style, and coping with illness. A preliminary survey.
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.
Department of Internal Medicine, University of Genova, Italy.
M
M
Marcenaro
C
C
Prete
A
A
Badini
A
A
Sulli
E
E
Magi
M
M
Cutolo
D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D001290:Attitude; D001883:Borderline Personality Disorder / Q000150:complications / Q000523:psychology; D003193:Compulsive Personality Disorder / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality / Q000502:physiology*; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*