SENSE OF COHERENCE - A PROTECTIVE FACTOR FOR DEPRESSION IN RHEUMATOID-ARTHRITIS

Objective. A stress-vulnerability model of depression was investigated in patients with rheumatoid arthritis (RA). Antonovsky's Sense of Coh erence (SOC) was examined as a factor protecting against depression. M ethod. Relationships between sociodemographic factors, disease activit y, functional impairment, pain, depression, and SOC were assessed usin g multivariate methods in a cross sectional sample of 89 consecutive o utpatients with RA. Results. Increased prevalence of depression was as sociated with low SOC and high self-rated pain levels, but not with ot her factors assessed, By multiple regression analysis, independent con tributions to depression were observed for SOC (23% of variance) and f or pain (24% of variance), but not functional impairment or disease ac tivity. Conclusion. Comprehensive models of adjustment in RA need to i nclude protective factors such as SOC, in addition to pain and other p athological variables. SOC may be helpful in identifying individuals w ith RA who are particularly vulnerable to depression, who may be helpe d by focused psychological interventions such as cognitive therapy.