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144 Grondin et al. | Journal of Clinical and Translational Research 2024; 10(2): 141-150
Table 2. Psychological assessments of patients with CIR versus other Table 2. (Continued)
diseases Psychological CIR (n=47) Other P‑value
Psychological CIR (n=47) Other P‑value parameters diseases
parameters diseases (n=12)
(n=12) Somatic escalade 14 (29.8%) 7 (58.3%) 0.093
Depression 38 (80.9%) 11 (91.7%) 0.67 Actual stress level 1
Depression intensity 0.4 Mild/moderate 44 (93.6%) 12 (100%)
Mild/moderate 32 (84.2%) 8 (72.7%) Severe 3 (6.4%) 0 (0%)
Severe 6 (15.8%) 3 (27.3%) Professional impact 0.064
Previous depression 37 (78.7%) 11 (91.7%) 0.431 Mild/moderate 22 (50%) 7 (87.5%)
Anxiety 47 (100%) 12 (100%) NA Severe 22 (50%) 1 (12.5%)
Anxiety intensity 0.174 Manual labor 28 (59.6%) 2 (16.7%) 0.008*
Mild/moderate 21 (44.7%) 8 (66.7%) Physical activity 23 (48.9%) 2 (16.7%) 0.043*
Severe 26 (55.3%) 4 (33.3%) enjoyment pre-diagnosis
Alexithymia 46 (97.9%) 11 (91.7%) 0.368 Physical activity 8 (17%) 1 (8.3%) 0.67
Alexithymia intensity 1 enjoyment post-diagnosis
Mild/moderate 20 (43.5%) 5 (45.5%) Note: Data are expressed as n (%) and compared using the Chi-squared test or Fisher’s
exact test accordingly; *P<0.05.
Severe 26 (56.5%) 6 (54.5%) Abbreviations: NA: Not applicable; CIR: Chronic inflammatory rheumatism.
Social desirability 0.431
Mild/moderate 37 (78.7%) 11 (91.7%) Temoshok [13] previously described the personality profile
Severe 10 (21.3%) 1 (8.3%) of RA patients as type C, characterized by submissive behavior,
Emotional repression 0.019* conciliatory approach, repression of hostility, self-effacement of
Mild/moderate 25 (53.2%) 11 (91.7%) personal needs, and depressive vulnerability. Grossarth-Maticek
Severe 22 (46.8%) 1 (8.3%) et al. [14,15] made similar observations in cancer patients.
Conflict-management 0.716 Bayle et al. [16] devised a psychological vulnerability score and
style obtained converging results close to the type C personality, and
Avoidance 37 (78.7%) 9 (75%) the scores were significantly higher for patients with secondary
Intermediate 10 (21.3%) 3 (25%) Raynaud’s syndrome than a control group with idiopathic or
Tendency to cede responsibility to others 0.501 primary Raynaud’s syndrome.
Mild/moderate 45 (95.7%) 11 (91.7%) Nagano et al. [17] demonstrated that rational and anti-emotional
Severe 2 (4.3%) 1 (8.3%) behaviors by RA patients, characterized by an extreme tendency to
Persecution complex 14 (29.8%) 1 (8.3%) 0.16 squelch emotional behaviors and rationalize negative experiences,
Somatic complaints 0.01* were associated with poorer prognoses. Ishii et al. [18] found that
Mild/moderate 32 (68.1%) 3 (25%) RA patients, who were easily brought to tears in response to stress,
Severe 15 (31.9%) 9 (75%) had better responses to treatment and better overall prognoses.
Collectively, previous studies and our present findings highlight
Psychological complaints 0.002* the importance of emotional dysregulation, especially emotional
Mild/moderate 33 (70.2%) 2 (16.7%) repression, on CIR etiology and prognosis. However, the present
Severe 14 (29.8%) 10 (83.3%) study should not be generalized as biased toward CIR or propose
Emotional expressivity 1 a secondary coping strategy for CIR. Emotional repression has
intensity also been considered a consequence of the CIR diagnosis instead
Mild/moderate 32 (68.1%) 8 (66.7%) of CIR itself [19,20].
Severe 15 (31.9%) 4 (33.3%) The intensity of key early life events was significantly more
Life event 1 29 (65.9%) 8 (72.7%) 1 severe for CIR patients than for those with other diseases. Cutolo
Life event 1 intensity 0.015* and Straub [21,22] reported that stressful events preceded RA
Mild/moderate 15 (51.7%) 8 (100%) onset for 86% of their patients.
Severe 14 (48.3%) 0 (0%) Several studies have associated severe life events with CIR
Life event 2 44 (93.6%) 11 (91.7%) 1 onset or flares, whereas other studies have associated CIR with
Life event 2 intensity 1 minor life events and daily stress. In contrast, we found no
Mild/moderate 30 (68.2%) 8 (72.7%) significant difference in the actual stress level presented by
Severe 14 (31.8%) 3 (27.3%) CIR and other diseases, probably because of a lack of statistical
Heavy conflictual load 40 (85.1%) 9 (75.0%) 0.409 power. Rimón and Laasko [23] described that higher stress at RA
over the last 3 years onset predicted a poorer prognosis for the disease. O’Donovan
(Cont’d...) et al. [24] also found that veterans experiencing trauma and

DOI: https://doi.org/10.36922/jctr.23.00099