Previous studies have suggested that worrying is associated with negative long-term impacts on disease severity, and experimental stress is known to lead to cortisol elevations and cytokine level alterations.
In the Annals of Rheumatic Diseases study, Andrea Evers and colleagues from the Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands set out to evaluate for a link between real-life stressors and subjective and objective assessments of disease activity, while integrating measurements of cortisol and pro-inflammatory cytokine levels.
Worrying specifically was predictive of more swollen joints and more pain 4 weeks later, while daily stressors, IL-1β and IFN-γ predicted fatigue 4 weeks later. Cortisol levels were not significantly altered in relation to disease activity in this group of patients.
The study characterizes the impact of psychological well-being on rheumatoid arthritis severity in the short term and highlights the importance of assessing and addressing patients’ life stressors and worrying as a critical part of managing this disease.