Personality profile in patients of rheumatoid arthritis-a Hospital based study

Background: Rheumatoid arthritis ( R.A.) is a common physical disorder having a prevalence of 0.3
– 2.1 % in the general population.1 Rheumatoid arthritis (RA) is an inflammatory, immune- mediated
disease with a prevalence of 0.5–1% in developed countries 2,3. American Rheumatology Association
(A.R.A.) developed revised criteria for diagnosis of R.A. in 1987 which includes – morning stiffness,
arthritis of 3 or more joint areas, arthritis of small joints, symmetric arthritis, R.A. nodule, Serum R.A.
factor positive and radiological changes. In RA, chronic synovial inflammation and hyper- plasia
drive articular destruction and bone erosion, leading to functional decline and disability. Literature on
identifying personality features that may characterize the R.A. patient is abundant and appealing. This
work has provided description of those patients as “shy, leading quiet lives and feeling inadequate and
inferior, “as self sacrificing and needing to serve others” “as conscientious, dutiful and compulsive,”
“as having a strict, rigid and moralistic conscience”. Since there is paucity of relevant data from
Kashmir, this study was designed to find the co morbidity in patients of Rheumatoid Arthritis in a
tertiary care teaching hospital in Srinagar, Kashmir.
Methods: Hundred successive patients presents with history of Rheumatoid Arthritis who fulfilled
inclusion and exclusion criteria were taken up for the study and administered the International
Personality Disorder Examination (IPDE) scale for evaluation of personality traits. Each patient was
informed about the purpose of interview; his/her consent was obtained and strict confidentiality was
ensured. General description, demographic data and psychiatric history were recorded using semi
structured Proforma and MINI.
Results: Out of hundred cases of Rheumatoid Arthritis, 42% of the patients were in the age group of
36-45 followed by 32% in age group of 26-35 years. This could suggest that Rheumatoid Arthritis
affects middle age group more. There were predominantly more males (64%) than females (36%) in
our study. Representations of gender, occupation and marital status have been found to be in
accordance with socio-demographic profile of our country. Cluster “C” was predominant personality
found in majority of patients.
Discussion: In our study, the most common cluster of personality was “C” , in which anxious
type(30%) of personality traits were found in most number of patients followed by dependent(245)
with least being paranoid and schizoid being 1% each.