title: Psychological distress across twelve months in patients with rheumatoid arthritis: the role of disease activity, disability, and mindfulness.
abstract: OBJECTIVE
  Mindfulness may diminish effects of adversities on psychological well-being in medical patients, but studies are scarce, especially in patients with rheumatoid arthritis (RA). The purpose was to examine the prospective moderating effect of mindfulness regarding psychological distress associated with disease activity and disability in patients with RA.
  
  
  METHODS
  Two-hundred-and-one patients with RA (mean age 57.4 ± 11.7, 55% women) completed questionnaires at baseline and at six and twelve month follow-up. Disease activity score was assessed by the rheumatologist.
  
  
  RESULTS
  Controlled for potential confounders, mixed linear model analyses showed a strong prospective association of higher baseline mindfulness with lower psychological distress up to the twelve month follow-up (p<.001). In addition, a mindfulness by disability by time interaction showed that higher baseline mindfulness was associated with lower disability related psychological distress at follow-up (p=.022).
  
  
  CONCLUSIONS
  Findings are in line with the hypothesis that mindfulness may protect against psychological distress associated with disability in RA. Potential benefits of mindfulness-based interventions for prevention should be examined in this population.
authors.affiliation: Center of Research on Psychology in Somatic disease (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, The Netherlands. Electronic address: i.nyklicek@tilburguniversity.edu.
authors.forename: Ivan
authors.initials: I
authors.lastname: Nyklíček
authors.affiliation: Department of Medical Psychology, Máxima Medical Center, Eindhoven, The Netherlands.
authors.forename: Frans
authors.initials: F
authors.lastname: Hoogwegt
authors.affiliation: Regional Rheumatic Center, Eindhoven, The Netherlands.
authors.forename: Toon
authors.initials: T
authors.lastname: Westgeest
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D057566:Self Report; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*
keywords: Disability; Disease activity; Mindfulness; Psychological distress; Rheumatoid arthritis