GENDER, PAID WORK, AND SYMPTOMS OF EMOTIONAL DISTRESS IN RHEUMATOID-ARTHRITIS PATIENTS

Objective. To evaluate the relative contribution of gender-related wor k conditions, gender-related socialization practices, and disease char acteristics to the explanation of emotional distress in men and women with rheumatoid arthritis (RA). Methods. Three hundred sixty-nine RA p atients who were employed outside the home were recruited from a natio nal randomized sample of rheumatology practices. Data on paid work and disease characteristics were obtained by telephone interview. Emotion al distress was measured by the Center for Epidemiological Studies Dep ression (CES-D) scale. Hierarchical ordinary least-squares regression was used to assess the relationship of sex, class, work characteristic s, and disease characteristics to both the CES-D summary scale and the CES-D factor structure. Results. Differences in emotional distress we re explained best by functional ability and pain and secondarily by th e characteristics of paid work, with no independent effect for sex. Di stress increased with decreasing functional ability, increasing pain, and exposure to such work characteristics as low autonomy, low income, and high demands. No sex differences in any of the CES-D subscales re mained after controlling for disease and work variables. Conclusion. A mong employed RA patients with high levels of functional disability an d exposure to stressful work characteristics, men and women are at equ al risk of experiencing emotional distress.