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© 1988 British Society for Rheumatology

research-article

DETERMINANTS OF DISABILITY IN RHEUMATOID ARTHRITIS

A.C. McFARLANE1, and P.M. BROOKS2

1Department of Psychiatry, School of Medicine, Flinders University of South Australia Bedford Park SA 5042
2Department of Rheumatology, Royal North Shore Hospital St. Leonards NSW 2065, Australia

Correspondence to: Address correspondence to Dr. McFarlane.

The longitudinal determinants of disability were studied in a group of 30 patients with rheumatoid arthritis over a 3-year period. The patients were investigated on two occasions using quantitative measures of disease activity and disability as well as a series of reliable psychometric instruments. Both longitudinal and cross-sectional data analyses were performed. Psychological factors consistently predicted more of the variance of disability than disease activity. These factors were associated with the tendency to deny the emotional dilemmas caused by having a chronic illness, difficulty in accepting doctors' reassurances and clinical depression. Such psychological variables required specific attention in rehabilitation programmes.

KEY WORDS: Depression, Impairment, Handicap, Rehabilitation, Psychological, Hostility, Illness behaviour


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