Relationship between self-rated functional status and psychosocial stress in patients suffering from rheumatoid arthritis

Background: To assess relationship between psychosocial factors and self-rated functioning in rheumatoid arthritis (RA). Methods: In 66 RA patients (mean age+/-SD = 50.8+/-12.6 years, women 49 (74%), illness duration mean+/-SD = 13.4+/-10.5 years) aspects of developmental psychosocial stress thought to influence human behavior were assessed in an in depth interview using structured biographical history. Furthermore evaluation included Trait anxiety, global functional status according to the ACR criteria, radiological staging of illness and patients' self-ratings of functioning obtained by the Health Assessment Questionnaire (HAQ). Bivariate correlations were performed using psychosocial and somatic factors and self-rated functional status. Results: Scores of developmental psychosocial stress significantly correlated with interviewers scoring of nurture (r = -0.722, p < 0.001) indicating good internal consistency of interview data. Significant correlations were found between patients' scoring of functional status (HAQ) and (i) ACR criteria (r = 0.490, p <0.0001) and (ii) score of Trait anxiety (r = 0.367, p <0.003). There was no significant correlation between developmental psychosocial stress and HAQ score. Conclusion: Developmental psychosocial stress does not significantly contribute as to how RA patients perceive their functional ability. In a proportion of RA patients self-rated functional status may depend on the patients disposition (e.g. neuroticism) probably promoting impaired illness behavior (e.g, regressive tendencies) which should be considered in assessing treatment procedures.