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Arthritis Care Res (Hoboken). 2019 Oct 10. doi: 10.1002/acr.24085. [Epub ahead of print]

Perceived stress and inflammatory arthritis: a prospective investigation in the Studies of the Etiologies of Rheumatoid Arthritis (SERA) cohort.

Author information

1
Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
2
Division of Rheumatology, University of Colorado School of Medicine, Aurora, CO, USA.
3
Nine Health Services, Inc, Denver, CO, USA.
4
University of Nebraska Medical Center, Omaha, Nebraska, USA.
5
Cedars-Sinai Medical Center, Los Angeles, California, USA.
6
Feinstein Institute Medical Research and North Shore-Long Island Jewish Health System, Manhasset, New York, USA.
7
The University of Chicago, Chicago, Illinois, USA.
8
Benaroya Research Institute at Virginia Mason, Seattle, Washington, USA.
9
David Geffen School of Medicine, University of California, Los Angeles, California, USA.

Abstract

OBJECTIVE:

The aim of this study was to determine the association of perceived stress with incident inflammatory arthritis (IA) defined as having at least 1 joint consistent with rheumatoid arthritis (RA)-like synovitis based on exam.

METHODS:

We conducted a prospective cohort study in the Studies of the Etiologies of Rheumatoid Arthritis (SERA). Participants without IA were recruited if they were a first degree relative of a RA proband or screened positive for anti-cyclic citrullinated peptide autoantibody (ACPA). Perceived stress was measured using the Perceived Stress Scale-14 (PSS) in which scores can range from 0 to 56 and a higher score indicates greater perceived stress. The total PSS score as well as two sub-scores indicative of perceived distress and self-efficacy were averaged across all study visits until development of IA or last follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) of IA associated with average PSS scores were obtained using Cox proportional hazards models.

RESULTS:

The mean total PSS score was 20.4. We found that a one-point increase in the perceived distress score was significantly associated with a 10 percent increase in the risk of IA (adjusted HR: 1.10; 95%CI: 1.02, 1.19). Total PSS and self-efficacy were not associated with IA risk (adjusted HR: 1.05 (95%CI: 0.99, 1.10) and 1.04 (95%CI: 0.91, 1.18), respectively.

CONCLUSIONS:

An association between perceived distress and incident IA was observed in this at-risk cohort. Replication of this finding in other preclinical and at-risk RA populations is needed.

PMID:
31600025
DOI:
10.1002/acr.24085

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