Stressful life events and disability in early rheumatoid arthritis

Abstract

The objective was to investigate the relationship of stressful life events and disability in early rheumatoid arthritis (RA), taking into account a possible stress-buffering effect of the social network. As part of a European study (EURIDISS), 337 early RA patients in France and The Netherlands (mean disease duration = 2.3 years) were interviewed for life events which had occurred in the past year. The social network composition was assessed using a standardized interview schedule and described by network density and proximity characteristics. Disability was assessed with the Health Assessment Questionnaire (HAQ) cross-culturally adapted to the French and Dutch languages. Subjects reported a median of 2 significant life events over the past year. On average they had 20 persons in their social network. The disability was significantly higher when the number of life events experienced was higher (r = 0.11; p<0.05) and when the number of social network members in monthly contact with the subjects was lower (r = −0.13; p<0.05). Controlling for country, the HAQ score increased significantly with the disease duration, disease activity variables, number of life events related to RA or to another health problem and decreased with the number of social network members. A significant (number of health-related life events)x(number of social network members) cross-product term entered the model which fitted the data better (R2 =0.51). Factors associated with disability are disease duration, disease activity, number of health-related life events and number of social network members in monthly contact. The results suggest a stress-buffering effect of the social network in coping with stressful life events in early RA.