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RA patients differed from controls in emotion-related personality traits
Patients with rheumatoid arthritis differed from controls in their emotion-related personality traits, and those differences might make them more susceptible to chronic stress and hypothalamic-pituitary-adrenal axis dysregulation, according to study results.
In a cross-sectional study, researchers in the United Kingdom evaluated 637 patients with rheumatoid arthritis (RA; mean age, 49.3 years; 90.6% women) and 496 healthy controls (mean age, 41.5 years; 53.2% women) who completed the Trait Emotional Intelligence Questionnaire. The questionnaire measured emotionality, sociability, self-control, well-being and global trait emotional intelligence (EI). Subgroup analysis included trait EI, rheumatoid factor (RF) status, depression and time from symptom onset to diagnosis.
RA patients rated themselves lower than controls on adaptability, stress management, emotion management, self-esteem, sociability, assertiveness, impulsiveness and well-being (P<.0025 for all). They rated themselves higher on empathy and relationships than controls (P<.0025 for both).
In the subgroup analysis of 222 RA patients, RF-negative patients (70.7%), when compared with RF-positive subtype patients (29.3%), reported longer depression (25.2 months vs. 11.3), longer diagnostic delay (3 years vs. 1.71 years) and greater emotional expression (5.15 vs. 4.72)(P<.05 for all). These significant differences were not found after applying rigid Bonferroni correction. Depression lasting three times longer (42.7 months) than three other subtypes (11-12.7 months) was reported by RF-negative patients with a longer diagnostic delay.
“RA may be a highly heterogenous illness where at least two subtypes may be characterized by personality, psychiatric and immunological differences,” the researchers reported. “RF-negative status, as well as diagnostic delay, and emotional expression, may predict future risk of depression.
“While previous work may have suggested that RA patients do not differ to healthy controls in their global trait EI scores, this paper suggests that they do score differently on eight specific trait EI personality facets. Each of these may, in theory, leave them vulnerable to chronic stressors and potential [hypothalamic-pituitary-adrenal] axis dysregulation. … Emotion-related personality traits appear to play a role as modulators or cofactors in the complex cascade of events that trigger the pathogenesis of RA.”