title: Social support and psychological distress in rheumatoid arthritis: a 4-year prospective study.
abstract: BACKGROUND
  The objective of the study was to investigate the course of psychological distress in early rheumatoid arthritis patients and to explore the strength of its associations with disease-related variables over time. A further aim focused specifically on the associations between social support and psychological distress.
  
  
  METHODS
  The study had a longitudinal design, with four annual measurements over consecutive years. The course and stability of psychological distress on the individual level were investigated via test-retest correlation coefficients and changes over time were studied using the Friedman test for repeated measurements. Hierarchical regression analysis was performed to analyze the multilinear associations of disease activity, functional disability, joint tenderness, pain and social support with psychological distress.
  
  
  RESULTS
  Significant cross-sectional associations were found among functional disability, joint tenderness, pain, emotional support, instrumental support and psychological distress. However, after controlling for the erratic pattern of the disease and the relevant variables, only initial psychological distress and emotional support retained a significant relationship with psychological distress. The final regression model, in which functional disability, pain, emotional support and initial psychological distress were significant variables, explained 36% of the variance in psychological distress.
  
  
  CONCLUSIONS
  The study stresses the importance of initial psychological distress, which was found to have the highest correlation with psychological distress experienced 4 years later. In addition, higher emotional support and lower pain were found to be the only variables independently associated with lower levels of psychological distress after controlling for the relevant variables.
authors: Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovak Republic. jozef.benka@upjs.sk
authors: Jozef
authors: J
authors: Benka
authors: Iveta
authors: I
authors: Nagyova
authors: Jaroslav
authors: J
authors: Rosenberger
authors: Anna
authors: A
authors: Calfova
authors: Zelmira
authors: Z
authors: Macejova
authors: Berrie
authors: B
authors: Middel
authors: Ivica
authors: I
authors: Lazurova
authors: Jitse P
authors: JP
authors: van Dijk
authors: Johan W
authors: JW
authors: Groothoff
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010146:Pain; D011446:Prospective Studies; D012044:Regression Analysis; D057566:Self Report; D012737:Sex Factors; D018154:Slovakia; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult