ILLNESS BEHAVIOR IN PATIENTS WITH ARTHRITIS

Objectives-To determine if there are specific patterns of illness beha viour in patients with arthritis, and if abnormal patterns of illness behaviour are associated with withdrawal from trials of antiinflammato ry drugs, and to examine which aspects of illness behaviour are percei ved by rheumatologists to be related to the disease process. Methods-T he illness behaviour questionnaire (IBQ) was administered to 211 patie nts with rheumatoid arthritis (RA) and 107 patients with osteoarthriti s (OA) participating in five drug trials of NSAIDs at the beginning of the studies, and was commented upon by 17 clinical rheumatologists . Results-Factor analysis of 211 patients with RA produced a unique fact or solution. RA patients were more preoccupied with their illness and its effects worried more about their health patients with OA. Patients who withdrew from drug trials showed behaviour patterns similar to th ose of chronic pain patients, and different from those of patients who completed the studies. When asked to account for a rheumatoid patient 's response to the IBQ, rheumatologists focused on physical symptoms a nd did not recognise some of the psychological issues which patients s aw as being relevant. Conclusions-We have demonstrated differences in illness behaviour between patients with OA and with RA. Patients withd rawing from drug trials of NSAIDs showed differences in illness behavi our compared with those successfully completing the trials. Rheumatolo gists underestimated the impact of the disease on their RA patients' p sychological well being.