Psychological factors in chronic rheumatic diseases--a review. The case of rheumatoid arthritis, current research and some problems.

An overview of studies relating psychological factors to perceived well-being among Rheumatoid Arthritis (RA) patients is presented. Most attention has been devoted to the perception of control, coping and the effects of cognitive distortions. The introduction of these constructs have advanced the understanding of psychological distress among RA patients, although they explain only a smaller part. One reason could be that they give an oversimplified picture of adjustment processes in chronic and disabling diseases. This may partly be because their development are based either on studies of depression in a psychiatric sense or on how healthy subjects manage stressful events in daily life. The results therefore have limited relevance for adjustment to a life-long, chronic illness like RA. Recent research has also suggested that personality dispositions, especially neuroticism, play a substantial role in all types of subjective experiences. Finally, some issues for future research are discussed.