Abstract
This review highlights the issue of psychosomatic conditions in rheumatoid arthritis,
paying special attention to new researches and trends in this field. Emerging concepts in all the major
parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain
on the emotional state to disease influence over quality of life, socio-psychological, and interpersonal
relationships. Chronic pain is closely related to emotional responses and coping ability, with a
pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual
disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading
to further decrease in quality of life, low compliance, and high suicide risk. Influence of psychosomatic
conditions on the overall treatment effect is usually underestimated by rheumatologists and
general practitioners. Psychosomatic considerations are of great importance for up-to-date management
of rheumatoid arthritis, as they strongly influence the quality of life, compliance, and
thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping
with pain through the regulation of emotion and psychotherapeutic intervention, which not only
helps patients in coping with the disease, but also aimed at improving the overall adaptation of the
patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy.
Current data about the efficacy of the additional correcting therapies for patients with rheumatoid
arthritis, both emerging and common ones, are discussed in the review.
Keywords:
Rheumatoid arthritis, psychological stress, anxiety, depression, quality of life, compliance.
Graphical Abstract
[1]
Folomeeva OM, Nasonov EL, Andrianova IA, et al. Rheumatoid arthritis in rheumatologic practice in Russia: the severity of disease in the Russian population of patients. Cross-sectional (transverse) epidemiological study (RAISER) 2010; 48(1): 40-50.
[2]
Chichasova NV, Vladimirov CA, Igolkina EG, Imametdinova TR. The burden of rheumatoid arthritis: health and social problems. Nauchno-prakticheskaya revmatologiya) 2009; 47(1): 4-10.
[3]
Nasonov EL, Baranov DA, Erdes SF, et al. Status of specialized rheumatology care for adults and children in the Russian Federation. Draft federal target program Rheumatic diseases 2008-2012 2007; 45(2): 4-7.
[6]
Dunbar F. IntroductionSynopsis of psychosomatic diagnosis and treatment. St Louis: CV Mosby and Company 1948; pp. 13-27.
[7]
Alexander F. Psychosomatic medicine: its principles and applications. New York: WW Norton Company 1965.
[8]
Kochyunas R, Guobis G. Psychological aspects of rheumatoid arthritis. Revmatologiya 1983; 1: 60-7. [in Russian]
[9]
Nikol’skaia EA. The psychological and psychopathological aspects of rheumatoid arthritis. Ter Arkh 1990; 62(10): 109-7. [in Russian]
[10]
Korshunov NI, Rechkina EV. [Rheumatoid arthritis: family and disease ] Ter Arkh 2005; 77(5): 29-32. [in Russian]
[11]
Korshunov NI, Filatov US, Yalseva NV, Rechkina EV. Score of some patient’s rheumatologist personal qualities and efficacy of treatment. Nauchno-prakticheskaya revmatologiya 2007; 45(3): 77-80.
[16]
Harris ML. Psychological factors in arthritis: cause or consequence?Psychosocial factors in arthritis: perspectives on adjustment and management. Heidelberg: Springer 2016; pp. 53-77.
[22]
Jeger JZ. Die Rolle des Rheumatologen bei der polydisziplinaren Begutachtung Rheumatol. Behav Res Ther 2007; 66(6): 66-72.
[30]
Grekhov RA, Kharchenko SA, Suleĭmanova GP, Aleksandrov AV, Zborovskiĭ AB. [Rheumatoid arthritis: psychosomatic aspects]. Ter. Arkh. 2012; 84(12): 125-30. [in Russian]
[62]
Zaĭtseva TV, Bagirova GG. [Quality of life in rheumatoid arthritis patients ] Ter Arkh 2000; 72(12): 38-41. [in Russian]
[63]
Ulanova EA. [Quality of life in anxiety disorders in patients with rheumatoid arthritis] Klin Med (Mosk) 2001; 79(1): 47-50. [in Russian]
[64]
Grekhov RA, Aleksandrov AV, Alekhina IIu, Zborovskiĭ AB. Use of life quality indices in the rehabilitation therapy of inflammatory and degenerative rheumatic diseases. Ter Arkh 2009; 81(12): 51-4. [in Russian]
[98]
Kremleva OV, Kolotova GB. [Patient non-compliance in rheumatoid arthritis: the degree, frequency, types and correlations ] Ter Arkh 2003; 75(5): 20-4. [in Russian]
[119]
Ublig T, Christie A. Spesialisert rehabffitering av pasienter med revmatisk sykdom. Laegeforen 2007; 127(3): 313-5.