Social stressors and risk of rheumatoid arthritis and their relationship to known modifiable risk factors: results from the Swedish EIRA study

Hedenstierna, Louise; Opava, Christina H.; Askling, Johan; Jiang, Xia; Ernestam, Sofia; Alfredsson, Lars; Klareskog, Lars; Saevarsdóttir, Saedís

doi:10.1080/03009742.2020.1813325

Cited by 2 publications

(2 citation statements)

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“…In that study, educational level did not influence the disease activity after 1 year; however, individuals with a lower educational level reported more pain at the 12-month follow-up. In another previous study, we observed an association between educational level and social support [20], which may explain the tendency towards higher levels of pain in patients reporting low social support observed in our present study. In a study from Great Britain that defined socioeconomic status based on residential area, low socioeconomic status was associated with an increased risk of a refractory RA disease [11].…”

Section: Discussionsupporting

confidence: 72%

“…The concept of psychosocial vulnerability is complex and not easily captured in a questionnaire, ours included. However, these exposures were associated with other characteristics of low socioeconomic status such as smoking and educational level [20], defining groups with clusters of risk factors that might influence the outcome. Moreover, decision latitude at work could only be assessed from the questions used during the first decade of the EIRA study and only applied to patients active in the labour market; thus, data were only available for a smaller subgroup of participants.…”

Section: Discussionmentioning

confidence: 99%

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Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study

et al. 2022

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Objectives To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA). Methods This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996–2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level. Results Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74–1.16), 12 (OR 0.96, 95%CI 0.75–1.23), or 60 (OR 0.89, 95%CI 0.72–1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54–1.31), 12 (OR 0.81, 95%CI 0.56–1.16), or 60 (OR 1.37, 95%CI 0.94–2.01) months. Conclusion In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%