Rheumatoid Arthritis: Phenomenology, Personality Profile, Stress and their Inter-Relationship.

ABSTRACT

The purpose of this study was to study the psychiatric morbidity of Rheumatoid Arthritis and to look for an association between disease parameters and personality dimensions of Rheumatoid Arthritis patients. Methods: 40 patients were selected from Rheumatoid Clinic of P.B.M.Hospital,Bikaner as per Association of Rheumatoid Arthritis (A.R.A.) revised criteria. The ICD-10 Module of International Personality Disorder Examination (IPDE),Social And Occupational Functioning Assessment Scale (SOFAS),Hamilton’s Rating Scale for depression(HAM-D),Presumptive Stressful Life Events Scale(PSLE) were administered to these patients .Bivariate statistical methods were used to find association between illness variables and psychological dimensions. Group differences were analyzed by students T-test and ANOVA. Results: Rheumatoid Arthritis patients with psychiatric morbidity showed higher R.A. severity (p<0.02), swan neck and valgus deformity (p< 0.05), more number of joints involved (p<0.01), smaller joints (metacarpo-phalangeal and inter-phalangeal) involvement (p<0.05), presence of C - reactive protein in blood samples (p<0.01). Majority of patients who had personality psychopathology also reported stress in preceding one year period. Personality level psychopathology either alone or in combination is present in 17 patients that is 42.5 % of the sample. Patients with single personality trait psychopathology were better in comparison to severe personality psychopathology in terms of number of joints involved, joint deformities, social and occupational functioning and psychiatric morbidity. Conclusion: Preliminary findings suggest that the severity of Rheumatoid Articles correlates with psychiatric morbidity.