TY - JOUR
T1 - Learned helplessness predicts functional disability, pain and fatigue in patients with recent-onset inflammatory polyarthritis
AU - Camacho, Elizabeth M.
AU - Verstappen, Suzanne M M
AU - Chipping, Jacqueline
AU - Symmons, Deborah P M
PY - 2013/7
Y1 - 2013/7
N2 - Objectives: Cross-sectional studies have found that learned helplessness (LH) is associated with disease outcome in patients with RA. However, little is known about the longitudinal impact of LH. The aim of this study was to investigate whether LH is associated with future disease outcome (disability, pain and fatigue) and to investigate whether LH changes over time in patients with recent-onset inflammatory polyarthritis (IP), the broader group of conditions of which RA is the major constituent. Methods: Patients included in this investigation had been recruited to the Norfolk Arthritis Register, a primary-care-based inception cohort. LH was measured at baseline as patients' total score on the Rheumatology Attitudes Index (RAI). A total of 443 patients completed the HAQ and visual analogue scales of pain and fatigue at baseline and after 2 years of follow-up. Results: Greater feelings of LH at baseline were associated with higher HAQ scores at follow-up [difference in HAQ score per 1-point increase in RAI score (b-coefficient) 0.02; 95% CI 0.01, 0.04]. Greater baseline LH was also associated with more pain (b-coefficient 1.0; 95% CI 0.4, 1.5) and more fatigue (b-coefficient 1.0; 95% CI 0.2, 1.4) at follow-up. LH was highly changeable during follow-up, with 87% of patients showing any change and 50% improving. Conclusion: Baseline LH independently predicted disability, pain and fatigue at follow-up. Half of patients reported fewer feelings of helplessness after 2 years of follow-up, suggesting that LH may potentially be a modifiable risk factor for disease outcome in IP and a target for intervention. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology.
AB - Objectives: Cross-sectional studies have found that learned helplessness (LH) is associated with disease outcome in patients with RA. However, little is known about the longitudinal impact of LH. The aim of this study was to investigate whether LH is associated with future disease outcome (disability, pain and fatigue) and to investigate whether LH changes over time in patients with recent-onset inflammatory polyarthritis (IP), the broader group of conditions of which RA is the major constituent. Methods: Patients included in this investigation had been recruited to the Norfolk Arthritis Register, a primary-care-based inception cohort. LH was measured at baseline as patients' total score on the Rheumatology Attitudes Index (RAI). A total of 443 patients completed the HAQ and visual analogue scales of pain and fatigue at baseline and after 2 years of follow-up. Results: Greater feelings of LH at baseline were associated with higher HAQ scores at follow-up [difference in HAQ score per 1-point increase in RAI score (b-coefficient) 0.02; 95% CI 0.01, 0.04]. Greater baseline LH was also associated with more pain (b-coefficient 1.0; 95% CI 0.4, 1.5) and more fatigue (b-coefficient 1.0; 95% CI 0.2, 1.4) at follow-up. LH was highly changeable during follow-up, with 87% of patients showing any change and 50% improving. Conclusion: Baseline LH independently predicted disability, pain and fatigue at follow-up. Half of patients reported fewer feelings of helplessness after 2 years of follow-up, suggesting that LH may potentially be a modifiable risk factor for disease outcome in IP and a target for intervention. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology.
KW - Fatigue
KW - Functional disability
KW - Inflammatory polyarthritis
KW - Learned helplessness
KW - Pain
KW - Rheumatoid arthritis
U2 - 10.1093/rheumatology/kes434
DO - 10.1093/rheumatology/kes434
M3 - Article
C2 - 23424265
VL - 52
SP - 1233
EP - 1238
JO - Rheumatology (Print)
JF - Rheumatology (Print)
SN - 1462-0324
IS - 7
ER -