TY - JOUR
T1 - Distinct psychological distress trajectories in rheumatoid arthritis
T2 - Findings from an inception cohort
AU - Norton, Sam
AU - Sacker, Amanda
AU - Young, Adam
AU - Done, D.J.
N1 - 'This is the author's version of a work that was accepted for publication in Journal of Psychosomatic Research. Changes resulting from the publishing process, such as structural formatting and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Psychosomatic Research, 71, 5, (2011)] 10.1016/j.jpsychores.2011.05.006'
PY - 2011
Y1 - 2011
N2 - Objective: As with other chronic physical illness, rates of depressive disorder are high in rheumatoid arthritis (RA). The aim of the current study was to identify distinct trajectories of psychological distress over 10 years in a cohort of RA patients recruited very early in the course of the disease.
Methods: Psychological distress as measured by the Hospital Anxiety and Depression Scale total score was assessed annually in a subgroup of 784 patients enrolled in a multi-centre RA inception cohort (Early RA Study). A latent growth mixture modelling (GMM) approach was used to identify distinct psychological distress patterns.
Results: Four distinct psychological distress trajectories were observed: low-stable (68%), high-stable (12%), high-decreasing (9%) and low-increasing (11%). Symptoms of pain, stiffness and functional impairment were significantly associated with levels of psychological distress at the time of diagnosis and after 3 years; serological markers of disease activity (ESR and CRP) were not.
Conclusions: Although the majority of individuals developing RA experience little or no impact of the effects of the disease on their psychological well-being, a significant proportion experience high levels of distress at some point which may be related to their subjective appraisal of their condition. Assessment and treatment of psychological distress should occur synchronously with somatic symptoms.
AB - Objective: As with other chronic physical illness, rates of depressive disorder are high in rheumatoid arthritis (RA). The aim of the current study was to identify distinct trajectories of psychological distress over 10 years in a cohort of RA patients recruited very early in the course of the disease.
Methods: Psychological distress as measured by the Hospital Anxiety and Depression Scale total score was assessed annually in a subgroup of 784 patients enrolled in a multi-centre RA inception cohort (Early RA Study). A latent growth mixture modelling (GMM) approach was used to identify distinct psychological distress patterns.
Results: Four distinct psychological distress trajectories were observed: low-stable (68%), high-stable (12%), high-decreasing (9%) and low-increasing (11%). Symptoms of pain, stiffness and functional impairment were significantly associated with levels of psychological distress at the time of diagnosis and after 3 years; serological markers of disease activity (ESR and CRP) were not.
Conclusions: Although the majority of individuals developing RA experience little or no impact of the effects of the disease on their psychological well-being, a significant proportion experience high levels of distress at some point which may be related to their subjective appraisal of their condition. Assessment and treatment of psychological distress should occur synchronously with somatic symptoms.
KW - Rheumatoid arthritis
KW - Psychological distress
KW - Depression
KW - Longitudinal
KW - Resilience
UR - http://www.scopus.com/inward/record.url?scp=80053963983&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychores.2011.05.006
DO - 10.1016/j.jpsychores.2011.05.006
M3 - Article
SN - 0022-3999
VL - 71
SP - 290
EP - 295
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
IS - 5
ER -