Living with arthritis: a "training camp" for coping with stressful events? A survey on resilience of arthritis patients following the COVID-19 pandemic

Clin Rheumatol. 2020 Nov;39(11):3163-3170. doi: 10.1007/s10067-020-05411-x. Epub 2020 Sep 26.

Abstract

Resilience is defined as "the capacity of individuals to cope successfully with significant change or adversity". The challenge posed by the COVID-19 pandemic may potentially represent an overwhelmingly stressful event for patients with chronic diseases. Aim of our study was to investigate the levels of resilience in individuals with inflammatory arthritis living in Emilia Romagna, the third hardest-hit Italian region during the ongoing COVID-19 pandemic. To this purpose, we developed a survey consisting of four different sections assessing demographic characteristics, the 14-item resilience scale (RS14) and questionnaires evaluating depression and anxiety. Consecutive patients with inflammatory arthritis were recruited over a short time frame immediately after the end of national lockdown and compared with control individuals from the general population. One hundred twenty-two patients and 173 controls were included. Levels of resilience, as measured by RS14 score, were significantly higher in patients with inflammatory arthritis (82.6 ± 14.0 vs 79.0 ± 12.8, p = 0.018). After stratification for gender, the difference in RS14 score was maintained in women (p = 0.045), but not in men (p = 0.252). High resilience, defined as having a RS14 score > 90, was significantly more prevalent in patients than in controls (30% vs 16%, p = 0.009). In arthritis patients, no significant differences in RS14 were observed after stratification for specific diagnosis, age, or disease duration and activity. Our findings suggest that patients with inflammatory arthritis may be more resilient than the general population towards unexpected stressful events such as the ongoing COVID-19 pandemic. Key Points • Living with inflammatory arthritis may foster resilience. • After COVID-19, patients with inflammatory arthritis were more resilient than the general population.

Keywords: Anxiety; Arthritis; COVID-19; Depression; Resilience.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Anxiety / psychology*
  • Arthritis, Psoriatic / psychology
  • Arthritis, Rheumatoid / psychology*
  • Betacoronavirus
  • COVID-19
  • Case-Control Studies
  • Coronavirus Infections*
  • Depression / psychology*
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral*
  • Resilience, Psychological*
  • SARS-CoV-2
  • Sex Factors
  • Spondylarthropathies / psychology*
  • Stress, Psychological / psychology*