Magazine article Clinical Psychiatry News

Personality Trait Can Worsen Rheumatoid Arthritis Symptoms

Magazine article Clinical Psychiatry News

Personality Trait Can Worsen Rheumatoid Arthritis Symptoms

Article excerpt

TUCSON, ARIZ. -- A psychological trait associated with heightened awareness of bodily distress may help to explain why some rheumatoid arthritis patients suffer more from achiness, malaise, and fatigue than do others with similar disease severity, Dr. Ilana M. Braun reported at the annual meeting of the Academy of Psychosomatic Medicine.

The trait, somatic absorption, was closely associated with generalized symptoms of rheumatoid arthritis in 87 patients studied by Dr. Braun, a psychiatrist at Harvard Medical School and Massachusetts General Hospital in Boston. It had no relationship to specific symptoms, such as joint pain, swelling, stiffness, and deformity, or to disease severity.

The magnitude of effect was modest, accounting for just 4% of variability in nonspecific symptoms, but Dr. Braun noted that it was significant statistically--and possibly clinically. People who score high on measures of absorption have a capacity for deep involvement in sensory events, she said. They have a heightened sense of reality that makes them more sensitive not only to bodily distress, but also to hypnosis and to biofeedback.

"There might be a role for psychiatry in the treatment of rheumatoid arthritis," she said, questioning whether some patients might respond to these kinds of interventions for nonspecific symptoms.

"It is a personality style that you can target," Dr. Braun added in an interview. "This is not a disorder. These are perfectly healthy people [mentally]. They just have a certain way of responding to the world."

While calling for more research into the clinical utility of her finding, Dr. Braun suggested that ultimately it may present rheumatologists with an alternative to increasing medication when patients complain they feel poorly in the absence of specific symptoms. "What I am saying is, for the malaise and the fatigue don't double the dose," she said. "Send them to the hypnotist. …

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