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Influence of patient personality in the treatment of rheumatoid arthritis

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Abstract

Individualized treatment of rheumatoid arthritis (RA) based on genetic/serologic factors is increasingly accepted. Moreover, patients are more actively involved in the management of their disease. However, personality has received little attention with respect to perception of the need and adherence to treatment. Our objective was to evaluate whether patient personality was associated with the acceptance or rejection of more aggressive early treatment. We performed a cross-sectional study in two hospitals with early arthritis clinics where sociodemographic, clinical, and therapeutic variables are systematically recorded. Patients completed Eysenck Personality Questionnaire, Multidimensional Health Locus of Control, Pain-Related Self-Statement Scale and Pain-Related Control Scale. Aggressive treatment was considered if patients received more than two DMARDs or biological agents during the first year of follow-up. Multivariate logistic regression analysis was performed to determine predictors of aggressive treatment. One hundred seventy-six RA patients were included (80 % women, disease begin median age 55 years). Treatment was considered aggressive in 57.9 % of the sample. Scores were high in extraversion in 50.8 % of patients, neuroticism in 29.5 % and psychoticism in 14.7 %. Neuroticism was the only factor associated with aggressive treatment, which was less probable (p = 0.04, OR = 0.40). Neuroticism also decreased the possibility of receiving a combination of biologics and DMARDs (p = 0.04, OR = 0.28). Patients with high scores on neuroticism are more worried, obsessive and hypochondriac, leading them to reject more aggressive therapy. It is important to educate about their disease so that they will accept more aggressive approaches in clear cases of poor outcome.

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Acknowledgments

This study was supported by the Instituto de Salud Carlos III (ISCIII), Ministry of Health, Spain. It was also funded in part by Fondo Europeo de Desarrollo Regional (FEDER) (Miguel Servet research contract CP11/00189 to Lydia Abásolo and CP12/03129 to Luis Rodriguez-Rodriguez; Fondo de Investigaciones Sanitarias grants PI11/00551 and PI14/00442; and Red de Investigación en Inflamación y Enfermedades Reumáticas Grants RD12/0009/0011 and RD12/0009/0017).

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Authors and Affiliations

  1. Rheumatology Department, IdISSC, Hospital Clinico San Carlos, Calle Profesor Martin Lagos S/N, 28040, Madrid, Spain

    Leticia Leon, Luis Rodriguez-Rodriguez, Juan A. Jover & Lydia Abasolo

  2. Universidad Camilo José Cela, Madrid, Spain

    Leticia Leon, Marta Redondo & Miguel A. Perez-Nieto

  3. Rheumatology Department, Hospital La Princesa, IIS La Princesa, Madrid, Spain

    Alberto Garcia-Vadillo & Isidoro Gonzalez-Alvaro

  4. Universidad Autónoma, Madrid, Spain

    Alberto Garcia-Vadillo

Authors
  1. Leticia Leon
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  2. Marta Redondo
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  3. Alberto Garcia-Vadillo
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  4. Miguel A. Perez-Nieto
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  5. Luis Rodriguez-Rodriguez
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  6. Juan A. Jover
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  7. Isidoro Gonzalez-Alvaro
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  8. Lydia Abasolo
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Correspondence to Leticia Leon.

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All authors declare that they have no conflict of interest related to the manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Isidoro Gonzalez-Alvaro and Lydia Abasolo shared senior authorship.

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Leon, L., Redondo, M., Garcia-Vadillo, A. et al. Influence of patient personality in the treatment of rheumatoid arthritis. Rheumatol Int 36, 1549–1555 (2016). https://doi.org/10.1007/s00296-016-3561-9

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  • DOI: https://doi.org/10.1007/s00296-016-3561-9

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