Health, Medical, and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University & Leiden University Medical Center, The Netherlands.
Health, Medical, and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University & Leiden University Medical Center, The Netherlands; Department of Psychiatry, Leiden University Medical Center, The Netherlands.
Best Pract Res Clin Rheumatol. 2016 Oct;30(5):932-945. doi: 10.1016/j.berh.2016.10.012. Epub 2016 Nov 20.
Inflammatory rheumatic diseases have a long-lasting effect on patients' physical and psychological functioning, for instance, due to disabling symptoms and unpredictable disease course. Consequently, many patients show adjustment problems such as depressed mood, which in turn can negatively influence their disease outcome. Specific biopsychosocial factors have shown to affect this outcome. For example, daily stress, cognitive-behavioral risk factors such as pain catastrophizing and avoidance, and resilience factors such as optimism and social support influence the quality of life, physical symptoms of pain and fatigue, and inflammatory markers. Psychological interventions tackling these factors can have beneficial effects on physical and psychological functioning. Recent advances in screening for patients at risk, tailored treatment, and eHealth further broaden the efficiency and scope of these interventions while simultaneously optimizing patient empowerment. This chapter describes the biopsychosocial risk and resilience factors related to disease outcome and the possible benefits of psychological treatment strategies in inflammatory rheumatic diseases.
炎症性风湿病会对患者的身心功能产生长期影响,例如由于症状致残和疾病进程不可预测。因此,许多患者表现出适应问题,如情绪低落,这反过来又会对他们的疾病结果产生负面影响。特定的生物心理社会因素已被证明会影响这一结果。例如,日常压力、疼痛灾难化和回避等认知行为危险因素,以及乐观和社会支持等适应力因素,会影响生活质量、疼痛和疲劳等身体症状以及炎症标志物。针对这些因素的心理干预可以对身心功能产生有益的影响。最近在筛查高危患者、量身定制治疗和电子健康方面的进展进一步扩大了这些干预措施的效率和范围,同时优化了患者的赋权。本章描述了与疾病结果相关的生物心理社会风险和适应力因素,以及炎症性风湿病中心理治疗策略的可能益处。