title: Psychological well-being in rheumatoid arthritis: relationship to 'disease' variables and affective disturbance.
abstract: BACKGROUND
  Resilience is likely to be important in understanding psychological responses to chronic physical illnesses. This study aimed to examine one measure of resilience--Ryff's operationalized measure of psychological well-being (PWB)--in rheumatoid arthritis. It was hypothesized that PWB would be influenced by age and gender in the same way as in community samples, and that the absence of current mood disorder would be associated with high PWB.
  
  
  METHODS
  Rheumatology clinic outpatients (n = 104) were assessed for pain, disease activity, disability, depression and anxiety. PWB was assessed using Ryff's six-subscale model. The measured variables were used in a logistic regression analysis to model the absence of clinically important mood disorder.
  
  
  RESULTS
  The expected variations in PWB according to age and gender were largely absent, with the overall findings suggesting that chronic illness in general, rather than arthritis in particular, affects PWB. Significant bivariate correlations were found between depression and pain, disease activity, disability and all six PWB subscales. However, in the regression analysis, only the PWB environmental mastery subscale and self-rated disability made significant contributions to the absence of mood disturbance, and their inclusion in the regression model correctly classified 81% of the total sample.
  
  
  CONCLUSIONS
  These results require replication in a longitudinal study, but indicate the potential value of using PWB among people with rheumatoid arthritis to screen for individuals who may be particularly vulnerable to developing depression. It might be appropriate to target such people with focused psychological interventions.
authors.affiliation: West Middlesex University Hospital, Isleworth, Middlesex, UK.
authors.forename: Lara
authors.initials: L
authors.lastname: Mangelli
authors.forename: Nora
authors.initials: N
authors.lastname: Gribbin
authors.forename: Stefan
authors.initials: S
authors.lastname: Büchi
authors.forename: Simon
authors.initials: S
authors.lastname: Allard
authors.forename: Tom
authors.initials: T
authors.lastname: Sensky
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D001007:Anxiety; D001172:Arthritis, Rheumatoid / Q000473:pathology* / Q000523:psychology*; D003863:Depression / Q000209:etiology* / Q000523:psychology; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010146:Pain; D012737:Sex Factors