title: Poor psychological health status among patients with inflammatory rheumatic diseases and osteoarthritis in multidisciplinary rehabilitation: need for a routine psychological assessment.
abstract: OBJECTIVE
  To examine psychological health status among patients with inflammatory rheumatic diseases (i.e. rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) and osteoarthritis in multidisciplinary rehabilitation, and to describe changes in psychological distress, illness cognitions, and pain coping from pre- to post-treatment.
  
  
  METHODS
  Eighty-nine patients referred to multidisciplinary rehabilitation completed a set of questionnaires to assess pain (AIMS2-SF), physical functioning (AIMS2-SF), psychological distress (IRGL), illness cognitions (ICQ) and pain coping (PCI) at pre- and post-treatment. Changes in physical functioning, pain, and psychological health status were determined. On the basis of the cut-off scores of psychological distress, distressed, and non-distressed patients were compared on physical and psychological outcomes.
  
  
  RESULTS
  Psychological distress was found in 64% of the study sample. In addition, high levels of helplessness and worrying, low levels of acceptance, and moderate levels of physical functioning were found. After treatment, positive changes in pain, psychological distress, and illness cognitions were observed. However, 69% (29/42) of the distressed patients at baseline still experienced elevated levels of psychological distress and maladaptive cognitions.
  
  
  CONCLUSIONS
  Psychological distress and maladaptive illness cognitions are important characteristics of this study sample, and psychological distress remains high after rehabilitation. More attention should be given to the appropriate assessment and treatment of psychological distress within multidisciplinary rehabilitation.
authors.affiliation: Sint Maartenskliniek, Department of Rheumatology, Nijmegen, The Netherlands. j.vriezekolk@maartenskliniek.nl
authors.forename: Johanna
authors.initials: J
authors.lastname: Vriezekolk
authors.forename: Agnes
authors.initials: A
authors.lastname: Eijsbouts
authors.forename: Andrea
authors.initials: A
authors.lastname: Evers
authors.forename: Annemiek
authors.initials: A
authors.lastname: Stenger
authors.forename: Frank
authors.initials: F
authors.lastname: Van Den Hoogen
authors.forename: Wim
authors.initials: W
authors.lastname: van Lankveld
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000523:psychology* / Q000534:rehabilitation*; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000523:psychology* / Q000534:rehabilitation*; D013315:Stress, Psychological / Q000453:epidemiology*