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A Personality Characteristic, Somatic Absorption, and the Perception of Somatic Symptoms in Rheumatoid Arthritis Patients
ILANA M. BRAUN, MATTHEW H. LIANG, E. JOHN ORAV, DAVID K. AHERN, and ARTHUR J. BARSKY
ABSTRACT. Methods. Patients completed self-report questionnaires assessing intensity of their RA symptoms, somatic absorption, and psychiatric distress. Disease activity and severity were measured through erythrocyte sedimentation rate, joint examination, and aggressiveness of medication regimen. We examined the cross-sectional association between somatic absorption and RA symptoms using multivariable regression analyses. Results. Somatic absorption was significantly (p < 0.05) associated with an overall measure of RA symptoms, and this association persisted after taking into account demographic data, disease severity, and extent of psychological distress. Somatic absorption was more closely associated with constitutional symptoms than with localized, articular symptoms of arthritis. Somatic symptoms were also independently associated with psychiatric distress (p < 0.001). Psychiatric distress was a more powerful predictor of extraarticular or constitutional symptoms than were measures of arthritis activity and severity. Conclusion. Our findings suggest that there may be a role for psychological intervention in the management of extraarticular symptoms of RA as these symptoms are relatively more influenced by a personality characteristic than the localized articular symptoms of the disease. (J Rheumatol First Release Mar 1 2008) Key Indexing Terms:
RHEUMATOID ARTHRITIS From the Department of Psychiatry, Massachusetts General Hospital; Department of Psychiatry, Brigham and Women's Hospital; Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital; Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts, USA. Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Research Grant 1R01 AR4701401. I.M. Braun, MD, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School; M.H. Liang, MD, MPH, Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; E.J. Orav, PhD, Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; D.K. Ahern, PhD; A.J. Barsky, MD, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School. Address reprint requests to Dr. I.M. Braun, Department of Psychiatry, Warren Building, Room 605, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail: ibraun@partners.org Accepted for publication December 3, 2007.
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