Perceived Stress and Inflammatory Arthritis: A Prospective Investigation in the Studies of the Etiologies of Rheumatoid Arthritis Cohort

Kristen J. Polinski, Elizabeth A. Bemis, Marie Feser, Jennifer Seifert, M. Kristen Demoruelle, Christopher C. Striebich, Stacey Brake, James R. O’Dell, Ted R. Mikuls, Michael H. Weisman, Peter K. Gregersen, Richard M. Keating, Jane Buckner, Perry Nicassio, V. Michael Holers, Kevin D. Deane, Jill M. Norris

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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 examination. Methods: We conducted a prospective cohort study in the Studies of the Etiologies of Rheumatoid Arthritis cohort. Participants without IA were recruited if they were a first-degree relative of an RA proband or screened positive for anti–citrullinated protein antibody. Perceived stress was measured using the Perceived Stress Scale–14 (PSS-14), in which scores can range from 0 to 56, and a higher score indicates greater perceived stress. The total PSS-14 score, as well as 2 subscores indicative of perceived distress and self-efficacy, were averaged across all study visits until development of IA or the last follow-up. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of IA associated with average PSS-14 scores were obtained using Cox proportional hazards models. Results: The mean total PSS-14 score was 20.4. We found that a 1-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-14 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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)1766-1771
Number of pages6
JournalArthritis care & research
Volume72
Issue number12
DOIs
StatePublished - Dec 2020

ASJC Scopus subject areas

  • Rheumatology

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