Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways.
Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways.
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DOI：
10.1038/nrrheum.2016.112
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Zautra AJ
中科院分区：
文献类型：
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作者：
Sturgeon JA;Finan PH;Zautra AJ
除了经常性疼痛，疲劳和身体残疾率增加外，类风湿性关节炎（RA）患者还表现出一些精神健康障碍的患病率增加，特别是那些涉及情绪障碍的疾病。这篇叙述性综述概述了类风湿关节炎的精神健康共病，并讨论了这些共病如何与疾病过程相互作用，包括炎症反应失调，疼痛和疲劳的长期困难，以及可能加剧与类风湿关节炎相关的生理和心理困难的认知和行为反应的发展。本文介绍了RA患者的社会背景如何影响他们的应对策略和对疾病的心理反应，也可以通过破坏治疗联盟和治疗依从性来损害对治疗的反应。来自慢性疼痛文献的证据表明，由此产生的奖励处理神经通路的改变可能会产生新的见解RA疾病过程和心理困扰之间的联系。最后，心理干预在有效和全面治疗类风湿关节炎的作用进行了讨论。
In addition to recurrent pain, fatigue, and increased rates of physical disability, individuals with rheumatoid arthritis (RA) show an increased prevalence of some mental health disorders, particularly those involving mood disturbances. This narrative Review provides an overview of mental health comorbidities in RA, and discusses how these comorbidities interact with disease processes, including dysregulation of inflammatory responses, prolonged difficulties with pain and fatigue, and the development of cognitive and behavioural responses that could exacerbate the physical and psychological difficulties associated with RA. This article describes how the social context of individuals with RA affects both their coping strategies and psychological responses to the disease, and can also impair responses to treatment through disruption of therapeutic alliance and treatment adherence. Evidence from the literature on chronic pain suggests that the resulting alterations in neural pathways of reward processing could yield new insights into the connections between disease processes in RA and psychological distress. Finally, the role of psychological interventions in the effective and comprehensive treatment of RA is discussed.