The Role of Sex, Perceived Pain, and Illness Perceptions in Disease Activity in Rheumatoid Arthritis

Background: In the “treating to target” strategy for Rheumatoid Arthritis (RA) management, “cognitive” beyond “physical” measures allow a more comprehensive assessment.  Objective: This study reported a predictive analysis of patients on disease activity and the degree to which these predictions could be uniquely attributable to Illness Perception (IP), pain, and sex differences. Methods: This cross-sectional study was conducted on 108 patients with Rheumatoid Arthritis aged 18 to 65 years old, selected via convenience sampling. Measurements were done using Disease Activity Score in 28 Joints (DAS28), patient’s Illness Perception Questionnaire (IPQ-R), and Numerical Rating Scale (NRS) for perceived pain. Data were analyzed applying Spearman and Pearson correlation coefficients and Multiple Stepwise Regression (MSR). Results:  In correlation analysis, the sex- Disease Activity association (0.40, P<0.01) and Pain-Disease Activity association (0.54, P<0.01) were found. Additionally, we observed stronger and significant associations between IPQ-R subscales and disease activity [Identity (r=0.53, P<0.01) personal control (r=-0.40, P<0.01) and emotional representation (r=0.36, P<0.01)]. Regression analysis showed that sex differences were a not significant predictor and perceived pain and three IPQ-R items (identity, personal control, and emotional representation) emerged as the strongest predictors (P<0.001). Conclusion: Disease activity was predicted by pain and three illness perception items. By identifying the components affecting Disease Activity, the therapist can adjust complementary treatment according to patients’ needs.