Psychological resilience and coping strategies in spondyloarthritis patients: A systematic review

Background: Spondyloarthritis (SpA) can considerably impact mental health, quality of life, and well-being via the occurrence of anxiety or depressive symptoms. A higher psychological resilience can protect patients from the distress that comes with the disease and aid in the successful adjustment to the illness. Understanding resilience and identifying the associated factors can help us offer early interventions to SpA patients. The aim of this work was to explore psychological resilience and coping strategies in patients with SpA and to investigate associated factors. Design: This review adhered to EQUATOR guidelines: The PRISMA 2020 guidelines for reporting systematic reviews and meta-analyses. Four electronic databases were searched (Pubmed, Cochrane, Web of Science, Scopus). Studies reporting results of resilience or coping strategies in SpA were screened. Results: Our literature search retrieved 21 studies, sixteen cross-sectional and five longitudinal studies. The total number of patients was 3,324: 1768 ankylosing spondylitis (AS), 1,768 psoriatic arthritis (PsA), and 1,223 axial spondyloarthritis (axSpa). Among the included studies, three reports involved a control group. Four studies investigated resilience among SpA patients and revealed high resilience scores. Seventeen studies examined coping strategies utilized by patients in response to their disease. Coping strategies varied across studies. Of the 17 studies, six reports showed a predominance of active and adaptative coping strategies. Six studies revealed a tendency to use cognitive coping strategies and five reports noted the use of evasive and maladaptative coping strategies. Higher disease activity, higher pain levels, and functional impairment were associated with low levels of resilience and passive coping strategies. Higher resilience and active coping were associated with lower risk of anxiety and depression. Among the four reports that investigated coping over time, three showed that coping strategies were stable. Conclusion: SpA patients displayed high levels of resilience. Coping strategies varied across studies. This present review emphasized the importance of psychological interventions in routine clinical practice to support patients. Patient and public contribution: No patient or public contribution