The role of psychosocial factor in rhematoid arthritis and ankylosing spondylitis
Olga S. Shubina1,2, Lubov A. Ukolova1,3, Larisa A. Bogoderova1, Natalia A. Shabanova1
1Novosibirsk State Regional Сlinical Hospital, Novosibirsk, Russia
gnokb@oblmed.nsk.ru
2Institute of Molecular Biology and Biophysics
3Novosibirsk State Medical University
gnokb@oblmed.nsk.ru
Keywords: хронические заболевания суставов, хроническая боль, психосоматические аспекты болезней суставов, нейробиоуправление, chronic joints disease, chronic pain, psychosomatic aspects of joints disease, neurobiofeedback
Abstract
The article is devoted to the study of the psychosomatic characteristics of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The study has been divided into 3 stages. The purpose of the first stage was to study the leading personality traits and prevailing types of attitude towards the disease in patients with RA and AS. The purpose of the second stage was to study the role of the social factor in RA patients based on the family pattern, to identify the relationship of intra-family problems with the duration and degree of the disease activity, the level of education. The third stage was aimed to demonstrate the effectiveness of biobehavioral therapy for the correction of pain in patients with RA. Material and methods. The contingent study consisted of patients with a reliable diagnosis of rheumatoid RA and AS, stage 1 - 26 patients (20 men, 6 women), stage 2 - 14 patients (11 women, 3 men), stage 3 - 46 women with RA. The patients underwent clinical, laboratory, X-ray examination. Psychological questionnaires and the Health Assessment Questionnaire (HAQ) were used. Results.: Hypochondria, increased anxiety, emotional immaturity, men’s behavioral characteristics in women have been revealed at the first stage of the study. In men with RA, the leading features are hypochondria, emotional immaturity. Types of attitude to the disease in women were: ergopathic 79 %, harmonious 37 %, neurasthenic 32 %; in men: ergopathic 57 %. The significant intercorrelation between the disease duration in women and the ergopathic and harmonious type of attitude toward the disease was found. The second stage of the study allowed the RA group to identify alienation, unwillingness and inability to independently solve family problems. According to the results of the third stage of the study, it was found that the patient’s acquired ability to control the alpha rhythm voluntarily allowed them to control the intensity of the pain syndrome and reduce the need for taking high doses of NSAIDs. A reduction of feelings of helplessness, hopelessness has been achieved. Conclusions. The study revealed psychological and social problems in patients with RA and AS, substantiating an interdisciplinary approach in the management of the patients with the rheumatologist and psychotherapist participation. Modern possibilities of psychotherapy can reduce the pharmacological burden in the treatment process.
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