The influence of Type D and Mindfulness on psychological well-being, quality of life and disease activity in rheumatoid arthritis patients.

Rheumatoid arthritis is a chronic disease. This disease leads to functional
disability. Patients confronted with the diagnosis of RA have to change their
way of living and they experience psychological distress. Individuals can vary
greatly in their psychological adaptation to the disease. Patients with a
comparable clinical picture and time since their diagnosis can evaluate their
quality of life quite differently. This means that other factors than only the
medical parameters may be responsible for these differences. There is little
research about the relation between personality and the individual differences
in quality of life and physical functioning in rheumatoid arthritis patients.
The influences of psychological factors in other diseases has been
investigated. Patients with cardiovascular diseases who score high on Type D
personality report a lower phycological well-being and physical functioning.
The influence of mindfulness has also been investigated. High scores on
mindfulness leads to a better psychological well-being, a better physical
functioning and decreases in inflammatory cytokines.
This personality factors could also be important in rheumatoid patients.
We hypothesize that:
1 a) Patients who score high on Type D personality report a lower
psychological well-
Being and quality of life.
1 b) Patients who score high on Type D personality show more severe disease
activity.
2 a) Patients who score high on mindfulness report a higher psychological
well-being and
quality of life.
2 b) Patients who score high on mindfulness show less severe disease activity.

In this research the effects of Type D and mindfulness on psychological
well-being and physical functioning is reported in two different treatment
groups. Rheumatoid arthritis is a chronic disease. Personality could be an
important factor in physical functioning and psychological well-being in an
individual patient. It is very important to know these effects to treat the
patients as good as possible.

The research design is a prospective follow-up study. The study time is 3
years. The first two years patients can be included in the study. After this, 1
year of follow up is included. All patients fill out the questionnaires at home
on three moments. Additional medical information is gathered from the medical
files. Follow-up moments are six (T1) and twelve (T2) months after baseline.

The burden of this research is minimal. Rheumatoid arthritis patients have
always their usual control appointments with the rheumatologist. The only extra
burden are the questionnaires. The answering takes half an hour at most. With 2
follow-ups this adds up to 1,5 hours at most.
The benefits of this study are potentially very important. When we know the
influences of personality on psychological well-being and physical functioning,
we can adjust our treatments to psychological profiels of patients associated
with enhanced or decreased risk, ameliorating our care.