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Rheumatology Advance Access originally published online on April 6, 2005
Rheumatology 2005 44(7):907-911; doi:10.1093/rheumatology/keh626
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Neuroendocrine–immune relationships between emotion regulation and health in patients with rheumatoid arthritis

H. van Middendorp, R. Geenen, M. J. Sorbi, L. J. P. van Doornen and J. W. J. Bijlsma1

Department of Health Psychology, Utrecht University and 1 Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.

Correspondence to: H. van Middendorp, Department of Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands. E-mail: H.vanMiddendorp{at}fss.uu.nl


  Abstract

Objectives. Emotion regulation is hypothesized to be related to health through neuroendocrine–immune changes. This study examined the role of the neuroendocrine variables 24-h urinary cortisol and noradrenaline, and the immune variable serum interleukin 6 as mediators between emotion regulation styles and health (perceived health and disease activity: erythrocyte sedimentation rate (ESR) and Thompson joint score).

Methods. Sixty patients with rheumatoid arthritis (mean age 59.0±11.2 yr; 38 female) participated.

Results. Emotion regulation was not associated with immune functioning or disease activity, but it was somewhat related to neuroendocrine functioning: one of the emotion regulation styles, ambiguity, was related to noradrenaline in women (r = 0.39) but not in men. The indicators of neuroendocrine functioning (cortisol and noradrenaline) were correlated (r = 0.40), as were indicators of immune functioning (interleukin 6) and inflammatory activity (ESR; r = 0.53), but analyses did not indicate a role of these physiological variables in mediating between emotion regulation and health: neuroendocrine variables were not related to interleukin 6 or ESR, and none of the physiological parameters was correlated with joint score or perceived health.

Conclusions. To examine whether the proposed mediational processes apply to individual patients, a longitudinal within-subjects design is needed. In our cross-sectional study, emotion regulation was somewhat related to neuroendocrine functioning, but our study did not uncover a potential mediational role of cortisol, noradrenaline or interleukin 6 in the relationship between emotion regulation and health in rheumatoid arthritis.

KEY WORDS: Emotions, Psychological adaptation, Alexithymia, Stress, Erythrocyte sedimentation rate, Interleukin-6, Noradrenaline, Cortisol, Psychoneuroimmunology, Rheumatoid arthritis

Submitted 20 December 2004; revised version accepted 25 February 2005.
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