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Longterm Predictors of Anxiety and Depressed Mood in Early Rheumatoid Arthritis: A 3 and 5 Year Followup ANDREA W.M. EVERS, FLORIS W. KRAAIMAAT, RINIE GEENEN, JOHANNES W.G. JACOBS, and JOHANNES W.J. BIJLSMA
ABSTRACT.
Methods. Anxiety and depressed mood, predicted from clinical and self-reported assessments of stress vulnerability factors at the time of diagnosis in 78 patients with RA were assessed again after 3 and 5 years. Results. A worse clinical status, more neuroticism, and lower education level at the time of diagnosis were all significantly related to increased psychological distress at the 3 and 5 year followup. However, the personality characteristics of neuroticism proved to be the most consistent and effective predictor of anxiety and depressed mood after 3 and 5 years, irrespective of initial distress levels, biomedical factors, use of medication, and other stressors or vulnerability factors. Conclusion. Results indicate the prognostic value of personality characteristics for longterm susceptibility to distress in patients with early RA, and emphasize the importance of paying close attention to factors unrelated to RA when screening for patients at risk. (J Rheumatol 2002;29:2327-36) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Department of Medical Psychology, University Medical Center St. Radboud; Department of Health Psychology, Utrecht University; and Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. Supported in part by grants from the Dutch League Against Rheumatism ("Nationaal Reumafonds"). A.W.M. Evers, MS, Psychologist, Department of Medical Psychology; F.W. Kraaimaat, PhD, Professor of Medical Psychology, Department of Medical Psychology, University Medical Center St. Radboud; R. Geenen, PhD, Psychologist, Department of Health Psychology, Utrecht University; J.W.G. Jacobs, PhD, Rheumatologist; J.W.J. Bijlsma, PhD, Professor of Rheumatology, Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht. Address reprint requests to A.W.M. Evers, University Medical Center St. Radboud, Department of Medical Psychology 118, PO Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: a.evers@cukz.umcn.nl Submitted August 13, 2001; revision accepted April 15, 2002.
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