Psychological Aspects of Rheumatic Diseases: Psychorheumatology in Clinical Practice

Rheumatic diseases (RDs) significantly impact patients' physical, psychological, and social well-being, yet psychological dimensions remain inadequately addressed in routine clinical practice. In this commentary, we examine psychological manifestations and mental health comorbidities in RDs, such as systemic lupus erythematosus, systemic sclerosis, Sjögren's disease, vasculitis, rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, axial spondyloarthritis, osteoarthritis, and fibromyalgia. Patients demonstrate high rates of depression (up to 90% lifetime prevalence), anxiety (18-65%), sleep disturbances (19-90%), chronic fatigue (31-89%), and alexithymia (25-59%). The prevalence of anxiety and depression is nearly double in RDs compared to the general population, whereas health-related quality of life is inferior to that in chronic conditions. These manifestations are bidirectionally linked to disease activity, pain intensity, and functional impairment. We propose the utilization of psychorheumatology, integrating psychological assessment, targeted interventions, and coordinated care between rheumatologists and mental health professionals.