The role of life events and childhood experiences in the development of rheumatoid arthritis

Objective. To evaluate the role of stressful life events, including negativ e childhood experiences on the development of rheumatoid arthritis (RA). Methods, Retrospective, community based, case-control study founded upon 11 6 cases, aged 45 to 74 years, registered with the Norfolk Arthritis Registe r (NOAR), who were also participants in the Norfolk European prospective In vestigation of Cancer study (EPIC). Three controls, matched for age and sex , were selected for each of the cases from among EPIC participants not suff ering from arthritis. Data on adverse experiences during childhood and adul thood were available from a self-report questionnaire. The 1987 American Rh eumatism Association (ARA) criteria for RA were met by 55 NOAR cases and th is subset provided the primary focus for analysis. Results. The number and timing of occurrence of stressful life events, as w ell as their subjective immediate impact, did not differ between participan ts who developed RA and their matched controls. Termination of pregnancy wa s the only specific event individually associated with a higher risk of dev eloping RA (OR 3.74; 95% CI 1.4-9.9). Negative childhood experiences were n ot associated with the risk of RA. However, RA cases reported significantly slower adaptation to the effects of adverse events: than controls. Conclusion. The results of this study do not support the hypothesis that th e rate of exposure or reported impact of stressful life events and of adver se childhood experiences play an etiologic role in the development of RA.