Rheumatoid Arthritis: The Impact of Mental Health on Disease: A Narrative Review

Rheumatology and Therapy
May N LwinChristopher J Edwards

Abstract

Over 60% of rheumatoid arthritis (RA) patients achieve a good response after 12 months of treatment when following the European league against rheumatism (EULAR) guidelines for treatment. However, almost half of patients still suffer from moderate to severe disease activity despite this. In addition, mental health problems may remain despite reduced measures of inflammation systemically and within joints. Depression is two times more common in RA patients than in the general population, and intriguingly a bi-directional relationship with RA has been shown in cross-sectional studies. Chronic inflammation impairs the physiological responses to stress including effective coping behaviours, resulting in depression, which leads to a worse long-term outcome in RA. In RA patients, the pain score is not always solely related to inflammatory arthritis and immunological disease activity by Bąk et al. (Patient Prefer Adherence 13:223-231, [1]). Non-inflammatory pain secondary to anxiety, depression, sleep disturbance and the psychosocial situation needs to be considered whilst fibromyalgia, mechanical pain and neuropathic pain can also contribute to overall pain scores by Chancay et al. (Women's Midlife Health 5:3, [2]). Hence, the UK Nat...Continue Reading

References

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Citations

Feb 4, 2021·International Journal of Molecular Sciences·Maria Sofia BasileEugenio Cavalli
Aug 28, 2021·Journal of Clinical Medicine·Juan L Prados-OjedaAlejandro Escudero-Contreras
Nov 28, 2021·European Journal of Nutrition·Maryam Ghaseminasab-PariziMasoumeh Akhlaghi
Jan 16, 2022·Rheumatology International·Swapna VijayanLatika Gupta

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