Illness perceptions account for variation in positive outlook as well as psychological distress in Rheumatoid Arthritis more

Psychological distress in rheumatoid arthritis (RA) is associated with adverse clinical outcomes, and appears highly related to patient’s illness perceptions. This study aimed to investigate the association between illness perceptions, psychological distress, positive outlook, and physical outcomes in RA. 230 patients aged > 18 years and prescribed at least one DMARD were recruited from outpatient clinics across Hertfordshire (England). Patients completed a questionnaire that assessed psychological distress and positive outlook (DAPOS), illness perceptions (IPQ-R), and functional disability (HAQ). Information regarding prescribed medication and disease activity (DAS28) was collected from medical notes. Psychological distress, but not positive outlook, was associated with functional disability and DAS28. After controlling for sex, age and DAS28, perceptions of greater symptomatology (identity) and lesser understanding of RA (coherence) were significantly associated with increased psychological distress. Perceptions of greater treatment control were associated with greater positive outlook, but only for those with low DAS28. Coherence was also associated with positive outlook. These findings indicate that illness perceptions may influence psychological distress and positive outlook in RA patients, and may therefore be a useful basis for future psychological interventions.