Determinants of disability in rheumatoid arthritis

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.