[Psychogenesis of rheumatoid arthritis--what do we really know?]

Empirical studies concerning the psychogenesis of rheumatoid arthritis are critically reviewed. Alexander's thesis that patients' suppressed aggressive impulses lead to increased muscle tension and hence to articular lesions has not thus far been given sufficient empirical support; there is not much evidence that people with rheumatoid arthritis show specific personality features, either. Human studies have not yet clearly demonstrated a connection between stressful life events and the onset or exacerbation of the disease; animal studies, in which the influence of stress on the development of rheumatoid symptoms was examined experimentally, have not yielded unambiguous results. However, these somewhat disappointing findings should not lead to the premature conclusion that psychological factors play no part in the development of rheumatoid arthritis.