Relationship between physical impairment, psychological variables and pain in rheumatoid disability. An analysis of their relative impact.

Forty-two consecutive female rheumatoid patients were given the AIMS questionnaire in order to determine their disability. Twenty-one had a second assessment one year later. Factorial analysis showed that the Italian version fully respects the construct of the original test. In fact four main factors (the physical, psychological, social and pain dimensions) arose, explaining 44.8%, 13.6%, 11.4% and 9% of the total variance, respectively. A close relationship was demonstrated between psychological variables, namely depression, and physical impairment, as shown by the correlation coefficient matrix. In order to determine whether depression might influence the ultimate outcome twenty-one patients were separated into two subsets according to their initial depression (greater than 5, less than 5). After one year, dexterity and pain were significantly worse in those with the highest depression score. This study shows that the psychological variables, in addition to physical impairment and pain, are of utmost importance in the outcome of rheumatoid patients.