Reactions to disability in patients with early versus established rheumatoid arthritis.
OBJECTIVE
This study examined differences in reactions to disability between early and established rheumatoid arthritis (RA) patients, and whether these reactions were related to age, physical functioning, acceptance of illness, or self-efficacy.


METHODS
Thirty-four patients with early RA (< 2 years since diagnosis) and 84 patients with established RA (> 4 years since diagnosis) completed the Reactions to Impairment and Disability Inventory (RIDI), and measures of anxiety, depression, acceptance of illness, self-efficacy, and physical functioning.


RESULTS
Early RA patients reported greater future denial than established RA patients. Younger patients reported more hostility than older patients. Accepting the illness was uniquely related to less anger and hostility. Higher self-efficacy for pain specifically related to greater shock, while patients with poorer self-efficacy for other symptoms reported worse anxiety, depression, shock, and anger.


CONCLUSIONS
Denial may be a coping strategy in the early stages of RA: anxiety, depression, shock, and anger appear to persist. Longitudinal studies of RA patients from diagnosis are required to plan interventions timed to maximize patient benefit and optimize healthcare resource utilization.
Treharne
G J
GJ
School of Psychology, University of Birmingham, Edgbaston, UK. GJT884@bham.ac.uk
Lyons
A C
AC
Booth
D A
DA
Mason
S R
SR
Kitas
G D
GD
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom