Longterm predictors of anxiety and depressed mood in early rheumatoid arthritis: a 3 and 5 year followup.

OBJECTIVE: Heightened levels of anxiety and depressed mood are known to be common consequences of rheumatoid arthritis (RA). We examined the role of stress vulnerability factors in the longterm course of anxiety and depressed mood in patients with early RA. Specifically, the role of personality characteristics (neuroticism, extraversion), physical and psychological stressors (clinical status, disease influence on daily life, major life events), and coping and social support at the time of diagnosis were studied to predict changes in anxiety and depressed mood 3 and 5 years later. METHODS: Anxiety and depressed mood, predicted from clinical and self-reported assessments of stress vulnerability factors at the time of diagnosis in 78 patients with RA were assessed again after 3 and 5 years. RESULTS: A worse clinical status, more neuroticism, and lower education level at the time of diagnosis were all significantly related to increased psychological distress at the 3 and 5 year followup. However, the personality characteristics of neuroticism proved to be the most consistent and effective predictor of anxiety and depressed mood after 3 and 5 years, irrespective of initial distress levels, biomedical factors, use of medication, and other stressors or vulnerability factors. CONCLUSION: Results indicate the prognostic value of personality characteristics for longterm susceptibility to distress in patients with early RA, and emphasize the importance of paying close attention to factors unrelated to RA when screening for patients at risk