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Grondin et al. | Journal of Clinical and Translational Research 2024; 10(2): 141-150 145
Table 3. Psychological assessments of patients with RA versus SpA Table 3. (Continued)
Psychological parameters RA (n=27) SpA (n=20) P‑value Psychological parameters RA (n=27) SpA (n=20) P‑value
Depression 21 (77.8%) 17 (85%) 0.713 Professional impact 0.006*
Depression intensity 0.197 Mild/moderate 17 (68%) 5 (26.3%)
Mild/moderate 16 (76.2%) 16 (94.1%) Severe 8 (32%) 14 (73.7%)
Severe 5 (23.8%) 1 (5.9%) Manual labor 12 (44.4%) 16 (80%) 0.014*
Previous depression 26 (96.3%) 11 (55%) <0.001* Physical activity enjoyment 10 (37%) 13 (65%) 0.058
Anxiety 27 (100%) 20 (100%) NA pre-diagnosis
Anxiety intensity 0.069 Physical activity enjoyment 5 (18.5%) 3 (15%) 1
Mild/moderate 9 (33.3%) 12 (60.0%) post-diagnosis
Severe 18 (66.7%) 8 (40.0%) Note: Data are expressed as n (%) and compared using the Chi-squared test or Fisher’s exact
test accordingly; *P<0.05.
Alexithymia 27 (100%) 19 (95%) 0.426 Abbreviations: NA: Not applicable; RA: Rheumatoid arthritis; SpA: spondyloarthritis.
Alexithymia intensity 0.172
Mild/moderate 14 (51.9%) 6 (31.6%) developing post-traumatic stress disorder (PTSD) could enhance
Severe 13 (48.1%) 13 (68.4%) the risk of developing autoimmune diseases, including RA. Based
Social desirability 0.481 on their study of Vietnam veterans, Boscarino et al. [25] reported
Mild/moderate 20 (74.1%) 17 (85%) that those with RA had more PTSD symptoms compared to those
Severe 7 (25.9%) 3 (15%) without RA.
The results of those studies are in agreement with a
Emotional repression 0.333 biopsychosocial model linking psychological stress and stressful
Mild/moderate 16 (59.3%) 9 (45%) life events with the etiology of autoimmune diseases. The impact
Severe 11 (40.7%) 11 (55%) of stress, resulting from an intense life event and aggravated by
Conflict-management style 0.481 conditions like emotional repression, would increase vulnerability
Avoidance 20 (74.1%) 17 (85%) to autoimmune diseases due to dysregulated immunity [26-30]
Intermediate 7 (25.9%) 3 (15%) and enhanced inflammation.
Tendency to cede responsibility to others 0.5 Herein, no significant difference was found between CIR and
Mild/moderate 25 (92.6%) 20 (100%) non-CIR patients regarding the frequency of depression disorders,
Severe 2 (7.4%) 0 (0%) depression severity, history of prior depressive episode(s), or
Persecution complex 10 (37%) 4 (20%) 0.207 anxiety symptoms.
Somatic complaints 0.381 Depressive and anxiety disorders are described as the most
Mild/moderate 17 (63%) 15 (75%) frequent comorbidities for CIR patients. Reynier-Legarçon
Severe 10 (37%) 5 (25%) et al. [31] found that patients with autoimmune diseases (systemic
Psychological complaints 0.207 lupus erythematosus, systemic scleroderma, or primary Sjögren
Mild/moderate 17 (63%) 16 (80%) syndrome) presented more severe depressive and anxiety
Severe 10 (37%) 4 (20%) symptoms than the general population. Baerwald et al. [32] found
Emotional expressivity intensity 0.132 that depressive disorders were significantly more common in RA
Mild/moderate 16 (59.3%) 16 (80%) patients than in the general population.
Severe 11 (40.7%) 4 (20%) Recently, Kang [33] investigated the effect of arthritis on
Life event 1 16 (66.7%) 13 (65%) 0.908 mental health using the 12-item version of the general health
Life event 1 intensity 0.837 survey (GHQ-12) and reported a total of three factors of GHQ-12,
Mild/moderate 8 (50%) 7 (53.8%) that is, GHQ-12A (social dysfunction and anhedonia; six items),
Severe 8 (50%) 6 (46.2%) GHQ-12B (depression and anxiety; four items), and GHQ-12C
Life event 2 24 (88.9%) 20 (100%) 0.251 (loss of confidence; two items), suggesting that both the global
mental health and dimensions of mental health are negatively
Life event 2 intensity 0.375 affected by arthritis. We were not able to replicate those findings,
Mild/moderate 15 (62.5%) 15 (75%) probably because of a lack of statistical power. In contrast, the
Severe 9 (37.5%) 5 (25%) homogeneity of our patients, in terms of depressive and anxiety
Heavy conflictual load 22 (81.5%) 18 (90%) 0.682 symptoms, attenuated any potential bias linked to their emotional
over the last three years dysregulation associated with these psychological comorbidities.
Somatic escalade 6 (22.2%) 8 (40%) 0.188 Moreover, no significant differences were found between
Actual stress level 0.251 the RA and SpA groups for the frequency of depression and
Mild/moderate 24 (88.9%) 20 (100%) depression severity. However, RA patients reported significantly
Severe 3 (11.1%) 0 (0%) more frequent prior depressive episodes than SpA patients, a
(Cont’d...) finding of which has never been reported previously. Nonetheless,

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