Death anxiety predicts fear of progression in people with rheumatic conditions

Rheumatic diseases often have a progressive course and place individuals at increased risk of mortality. Despite this, little research has investigated the relationship between death anxiety and fears about disease progression (FoP), and how these might relate to health-related quality of life (HRQoL) outcomes. This study investigated the relationship between death anxiety, FoP and HRQoL.

A cross-sectional design with a longitudinal follow-up at 3 months.

A total of 145 participants with at least one rheumatic condition were recruited through Prolific. They completed online questionnaires assessing FoP, death anxiety, HRQoL, pain and psychological distress. They also completed an additional measure of FoP 3 months later. A series of regression analyses were conducted to examine whether death anxiety predicted unique variance in FoP cross-sectionally, as well as three months later. We also investigated whether death anxiety and FoP were associated with HRQoL after controlling for pain, demographics and psychological distress.

Death anxiety contributed unique variance to FoP, even when controlling for other variables of interest, and continued to predict FoP 3 months later. Surprisingly, neither death anxiety nor fear of progression were found to predict unique variance in psychological or physical HRQoL.

These results indicate that death anxiety plays an important role in FoP. As such, death anxiety appears to be a particularly pertinent factor in the experience of FoP for people with rheumatic conditions that deserves further investigation. However, quality of life outcomes may be robust to the impact of death anxiety and FoP.