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Cited by 33Rheumatoid Arthritis Research and TherapiesEmotional Intelligence and PerformancePsychosomatic Disorders and Their Treatments

Possible rheumatoid arthritis subtypes in terms of rheumatoid factor, depression, diagnostic delay and emotional expression: an exploratory case-control study

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Tillmann, Taavi, Krishnadas, Rajeev, Cavanagh, Jonathan, Petrides, KV·2013·Arthritis Research & Therapy
DOI 10.1186/ar4204PMC PMC3672797
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Abstract

Introduction: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathology of rheumatoid arthritis (RA), particularly as vulnerable personality types are exposed to chronic stress. Emotions are powerful modulators of stress responses. However, little is known about whether patients with RA process emotions differently to matched controls. In this study we: 1) assessed whether the trait emotional intelligence (trait EI) scores of patients with RA differ from healthy controls at the facet level; 2) explored any subgroups in RA, in terms of trait EI and common risk factors. Methods: A total of 637 patients with RA were compared to 496 controls on the trait EI Questionnaire (TEIQue). RA subgroups were explored in terms of trait EI, rheumatoid factor status (RF+/-), depression and time from onset of symptoms until diagnosis (diagnostic delay). Results: The RA group rated themselves lower on Adaptability, Stress-management, Emotion management, Self-esteem, Sociability, Assertiveness, Impulsiveness and Well-being, and higher on Empathy and Relationships than healthy controls. The RF- subtype reported more time with depression (25.2 vs. 11.3 months), a longer diagnostic delay (3.0 vs. 1.7 years), and greater emotional expression (5.15 vs. 4.72), than the RF+ subtype. These differences were significant at the P <0.05 level, but not following strict Bonferroni corrections and should therefore be treated as indicative only. RF- patients with a longer diagnostic delay reported depression lasting three times longer (42.7 months), when compared to three other subtypes (11.0 to 12.7 months). Conclusions: RA patients and controls differ in their emotion-related personality traits, as operationalized by trait EI. These differences may make people with RA more susceptible to chronic stress and HPA-axis dysregulation. RA may be a highly heterogeneous illness where at least two subtypes may be characterized by personality, psychiatric and immunological differences. RF- status, as well as diagnostic delay and emotional expression, may predict future risk of depression. Research on the causes of RA could benefit from a systems science approach.

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  • High cortisol secretions over long periods may eventually lead to inflammatory and other somatic conditions.

    “Trait EI is linked to lower cortisol secretion in stressful situations (Laborde, Lautenbach, Allen, Herbert, & Achtzehn, 2014; Mikolajczak, Roy et al., 2007), which is advantageous because high secretions over long periods may eventually lead to inflammatory and other somatic conditions (Tillmann, Krishnadas, Cavanagh & Petrides, 2013).”

    From Developments in Trait Emotional Intelligence Research (2016) · cites this paper as Tillmann, Krishnadas, Cavanagh & Petrides, 2013

    The Discussion (page unavailable) says chronic stress may dysregulate the HPA axis, leading to inflammatory dysregulation that may contribute to rheumatoid arthritis. The Introduction mentions increased cortisol in some stress responses, but the paper does not say that prolonged high cortisol secretion causes inflammation or other somatic conditions. (LLM, conf=0.85)

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Authors
Tillmann, T., Krishnadas, R., Cavanagh, J., & Petrides, K.
Affiliations
Southern General Hospital (GB)
Corresponding author
Tillmann, Taavi
ORCID
Venue
Arthritis Research & Therapy
Publisher
Springer Science and Business Media LLC
Published
2013-03-21
Volume
15
Issue
2
Pages
R45-R45
ISSN
1478-6354 (ISSN-L)
DOI
10.1186/ar4204
PMC
PMC3672797
OpenAlex
W2170188698
Cited by
33
References
87
Citations by year
2025: 1 · 2023: 2 · 2022: 6 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 6 · 2015: 2 · 2014: 3 · 2013: 2
FWCI
3.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Arthritis Research & Therapy (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • Arthritis Society
  • National Institute for Health and Care Research (ACF-2013-17-013)
Topics
  • Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
  • Social Sciences › Psychology › Social Psychology › Emotional Intelligence and Performance
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
rheumatoid arthritis, rheumatoid factor, trait emotional intelligence, depression, delayed diagnosis, emotional expression, hypothalamic-pituitary-adrenal axis, chronic stress, personality traits, disease heterogeneity
MeSH terms
Adult, Arthritis, Rheumatoid, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Rheumatoid Factor, Case-Control Studies, Emotional Intelligence, Delayed Diagnosis

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