Background In RA pts, health-related quality of life (HRQoL) assessment is important, but there is little research regarding the relation between the type of personality and the individual differences in HRQoL1. Optimism and the tendency to hold greater positive outcome expectancies have been found to be related with better psychological well-being in RA pts, while negative affectivity (components of type C and D personality) are reported to show lower health satisfaction scores2.
Objectives The aim of the present study was to investigate the association of different types of personality with aspects of HRQoL and disease activity in RA pts.
Methods This cross-sectional study included 104 RA pts from two different Rheumatology Departments (7.7% men, 92.3% women, mean age 59.08, mean duration of disease 12.77 years). Personality type was assessed with Jenkins Activity Survey for type A/B, State-Trait Anger Expression Inventory Anger-in Scale (AIS) for type C and Type D Personality Scale (DS14), with its components (negative affect-NA and social inhibition-SI) for type D. HRQoL was quantified using the Medical Outcome Study Short-Term-36 (SF36v2) and its subscales (Physical function-PF, Social function-SF, Role physical-RP, Role emotional-RE, Mental health-MH, Vitality-VT, Bodily Pain-BP, Global Health-GH, physical component scores-PCS and mental component scores-MCS). Disease activity was evaluated with Disease Activity Score (DAS28) and visual analog scale (VAS) for pain.
Results Type C pts correlate with decreases in HRQoL in 7 of its 8 subscales when compared to non-C personality pts (RP M=15±28.56/M=3.14±38, VT M=32.57±2.23/M=44.63±22.68, RE M=27.62±39.18/M=49.99±44.05, MH M=39.54±25.88/M=62.64±22.44, MCS M=36.98±13.33/M=46.52±12.36; p<0,05), whereas type D pts show lower values only in 5 of 8 components when compared to non-D (RP M=4.68±1/M=29.06±37.54, GH M=28.75±13.6/M=38.63±23.99, VT M=25±17.88/M=43.83±21.93, SF M=49.21±27.18/M=63.6±25.18, RE M=8.33±19.24/M=49.22±43.9, MH M=26.75±22.75/M=6.51±22.71, MCS M=29.89±11.17/M=45.98±12.22; p<0,05). Less features of type C associate with better MH (r=-.58) and less type D traits (smaller the NA and SI) with better MCS (rNA=-.55, rSI=-.38). Type C and D pts also have increased disease activity levels, not only related to DAS28, but also to PGA. Type A pts assess pain by VAS to be lower than those with type B (M=56.5±34.94 vs 84.66±15.09, p<0,05), with no other significant correlations.
Conclusions The present study showed associations between type C and D personalities with negative effects on several components of HRQoL in RA pts and also with higher disease activity. We did not find significant correlations with type A personality, except for a lower pain assessment. Future research including prospective follow-up assessments is needed in order to determine if the personality type influences the evolution of disease and the response to treatment in RA patients.
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Treharne GJ, et al. Br J Health Psychol.2007;12(1):323–345.
Disclosure of Interest None declared