DETERMINANTS OF PSYCHOLOGICAL DISTRESS AND ITS COURSE IN THE FIRST YEAR AFTER DIAGNOSIS IN RHEUMATOID-ARTHRITIS PATIENTS

In order to examine determinants of psychological distress and its cou rse in the first year after diagnosis in rheumatoid arthritis patients self-report data and clinical and laboratory measures were collected in 91 patients (70% female, mean age 57 years) shortly after diagnosis and 1 year later Multiple regression analysis indicated that sex, pai n and functional status, disease impact on daily life, life events, an d perceived social support were related to psychological distress (anx iety and depressed mood) shortly after diagnosis. Coping strategies we re related to distress levels only 1 year later. Multiple regression a nalysis of change in anxiety and depressed mood revealed that a decrea se of psychological distress after 1 year could be predicted by male s ex, an initially less severe inflammatory activity and an initially mo re extended social network. In addition, a decrease in distress was re lated to parallel improvements in clinical status. Results indicate th e importance of a multimodal assessment of demographic variables, clin ical and life stressors and social resources for the understanding of distress and the identification of risk factors in the first stage of the disease. Personal coping resources appear to become more important predictors of distress in a later phase of the disease.