Social, economic, psychologic, and sexual outcomes in rheumatoid arthritis

Rheumatoid arthritis takes an economic toll in a variety of ways--the actual costs of treatment for the individual patient and society are only a fraction thereof. Other costs derive from the legal definition of disability, from a lack of employment opportunities, from premature retirement from work, and from the social and familial consequences of these events. Depression is a major feature of chronic disease and colors both behavior by the patient and the doctor-patient relationship. Self-image suffers in this potentially deforming disease, with consequences in sexual and social behavior. Ignorance and a confusion between disability and handicap lead to more disablement than do the physical changes of rheumatoid arthritis.