title: Life events, emotional responsiveness, and the functional prognosis of patients with rheumatoid arthritis.
abstract: BACKGROUND
  Stressors may differently affect human physiological systems according to the host properties relevant to psycho-behavioral processes that the stressors invoke. In a Japanese multicenter cohort study of patients with rheumatoid arthritis (RA), we examined if major life events differently contribute to the patients' functional prognosis according to their ability to identify emotions as manifest feelings when encountering the events (emotional responsiveness).
  
  
  METHODS
  460 patients with RA completed a self-administered baseline questionnaire about psychosocial factors including emotional responsiveness. Two years later, they checked on a list of positive/negative personal events that happened during the two-year study period. Rheumatologists evaluated their functional status at baseline and follow-up using the ACR classification system.
  
  
  RESULTS
  In a multiple logistic regression model that included baseline demographic, disease activity/severity-related, therapeutic, and socioeconomic factors as covariates, none of the counts of positive, negative, or all life events was associated with the functional status at follow-up. In the subgroup with poor emotional responsiveness, however, these life event counts were all associated with a poorer functional prognosis (odds ratio of ACR class 3-4 vs. 1-2 associated with one increment in the all life-event count = 2.39, 95 % confidence interval = 1.27-4.48, p = .007), while no such relationship was evident for the rest of the patients.
  
  
  CONCLUSIONS
  Major life events, whether positive or negative in nature, may have an impact on the disease course of patients with RA when the patient has poor emotional responsiveness to the event(s).
authors.affiliation: Faculty of Arts and Science, Kyushu University, 6-1 Kasuga Park, Kasuga, Fukuoka 816-8580 Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nagano
authors.affiliation: Department of Psychosomatic Medicine, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sudo
authors.affiliation: Yokohama Minami Kyousai Hospital, 1-21-1 Mutsu-ura Higashi Kanazawa-ku, Yokohama, 236-0037 Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Nagaoka
authors.affiliation: Yukioka Hospita, 2-2-3 Ukida, Kita-ku, Osaka 530-0021 Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Yukioka
authors.affiliation: Kondo Rheumatism and Orthopedics Clinic, 3-10-11 Tenjin, Chuo-ku, Fukuoka 810-0000 Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kondo
keywords: Arthritis; Emotions; Function; Personality; Prospective studies; Psychological; Rheumatoid; Stress