The relationship between mental health and rheumatism

Objective: Firstly to get an impression of mental health among individuals with rheumatic diseases and to investigate factors associated with its three facets: emotional, social and psychological well-being. Secondly to explore how much variance these factors can explain in mental health. We are interested in establishing whether mental or physical factors play the bigger role. Methods: This study was accomplished in the rheumatology department of the clinic “Medisch Spectrum Twente” in collaboration with the University Twente in Enschede. We compared the mental health of our sample with that of the general Dutch population (Westerhof and Keyes, 2008). 66 patients filled in Short form version2 (SF-36), Health assessment questionnaire – disability Index (HAQ-DI) and the Mental Health Continuum– Short Form (MHC–SF). They measure respectively Health (mental and physical), Disability and mental health (consists of three facets: emotional, social and psychological well-being). Results: Compared to the general Dutch population more people of our sample are languishing (difference: 5.7%) as well as flourishing (difference: 22.7%) and less moderately healthy (difference: 28.4%). Following constructs correlated significantly with emotional well-being (p<0.05): Role limitations due to physical and emotional problems, General health perception, Vitality, Social functioning, emotions (mental health) and disability. Social wellbeing correlates significantly (p<0.05) with vitality, role limitation due to emotional problems and emotions (mental health). Psychological well-being correlates significantly (p<0.05) with general health perception, vitality, social functioning, role limitation due to emotional problems and emotions (mental health). With multivariate regression analyses we found that the health factors explain 55% of emotional, 27 % of social and 21 % of the variance in psychological well-being. Discussion: Role restriction due to emotional problems and vitality are the strongest predictors for mental health. It should be tried to find ways to influences them in order to increase mental health among the rheumatism population. Emotional well-being is strongly influenced by health factors whereas social and psychological well-being is less affected. In contradiction with our expectance, pain shows no significant correlation with any of the three mental health facets. All other factors show at least a relation with one of the mental health facets. More mental factors correlate with mental health and their correlation is generally higher than that of physical factors. It seems thus that mental health is more affected by the psychological consequences of rheumatism rather than from rheumatism itself. Further research should investigate whether physical factors influence mental health indirectly via mental factors. Attention should be paid to the high prevalence of flourishing people in our study. Maybe flourishing people were more inclined to take part in our study than languishing ones.