Overt psychopathology in rheumatoid arthritis. A fifteen-year follow-up study

A 15-year follow-up study of 74 female patients (mean age 57.9 years) with definite or classic rheumatoid arthritis (RA) was performed, with special emphasis on overt psychopathology during the clinical course of the illness. Catamnestic investigation revealed that in 46% of the patients psychiatric disturbances necessitating treatment had appeared during the follow-up period. Generally, the psychiatric syndromes observed were of neurotic type not infrequently associated with depressive symptomatology. At the time of investigation 41% of the patients exhibited overt psychopathology, of whom the majority had depressive reactions (40%) or other forms of neurotic syndromes (18%). Only one patient was diagnosed as psychotic. In 5 instances distinct signs of chronic organic brain syndrome were noted. The importance of identifying clinical depression and of instituting adequate drug treatment and psychotherapy is emphasized.