Emotional repression in patients with chronic inflammatory rheumatism

Background: A person’s psychological background may support and direct the inflammatory evolution of a disease toward a specific type of chronic inflammatory rheumatism (CIR). Aim: This study aimed to identify a particular emotional profile of patients with CIR, particularly rheumatoid arthritis (RA) and spondyloarthritis (SpA), based on psychological profile assessments between patients with and without CIR. Emotional repression, that is, a tendency to inhibit the expression of negative feelings and/or unpleasant thoughts, was particularly studied. Methods: This monocentric observational pilot study included patients from the rheumatology department of a university hospital. These patients were systematically assessed for different psychological parameters by an experienced psychiatrist, and their clinical and biological characteristics were collected accordingly. Data analysis was performed using the Chi-squared test or Fisher’s exact test. Results: Fifty-nine patients were assessed: 47 patients with CIR (i.e., 27 with RA and 20 with SpA) (CIR group) and 12 non-CIR patients (i.e., nine with osteoarthritis, one with viral disease, one with osteoporosis, and one with osteomalacia) (control group). Severe emotional repression and early life events were both significantly higher in the CIR group than in the control group (P = 0.02). In contrast, severe psychological and somatic complaints were significantly higher in the control group than in the CIR group (P < 0.01 and P = 0.01, respectively). Conclusion: Our findings suggested that emotional repression from traumatic life events could aggravate the etiology and/or course of CIR. Therefore, appropriate psychological care should have a relevant place within the current therapeutic options for the clinical management of CIR. Relevance for Patients: The management of CIR should include psychological support as learning coping mechanisms can facilitate the recovery of CIR patients.