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  • Review Article
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Stress and resilience in rheumatic diseases: a review and glimpse into the future

Abstract

Stress resilience factors, and interventions to ease stress and enhance resilience, are gaining increasing attention for the treatment of rheumatic conditions. This Review presents a digest of empirical work on the factors that determine the risk of adapting poorly to a rheumatic condition, and on the resilience factors that counteract such risks. We consider the types of stress-management and resilience treatments that are most effective in promoting the physical and psychological functioning of patients at risk of long-term adjustment problems. Prospective research shows that cognitive–behavioral and social risk and resilience factors predict the long-term physical and psychological functioning of patients with rheumatic conditions. Furthermore, validated screening instruments are becoming increasingly useful in clinical practice to identify and select patients at risk. Stress-management and resilience interventions offer promising ways to improve the long-term functioning of patients. These treatment methods might be especially useful when they are tailored to the specific risk and resilience factors of patients, and when they incorporate innovative approaches to the delivery of services, including internet applications such as eHealth, to increase efficiency and availability of treatments, and to optimize patient empowerment in rheumatic conditions.

Key Points

  • Cognitive–behavioral risk (for example, pain-avoidance and worrying) and resilience factors (such as social support) are predictive for the long-term physical and psychological functioning of patients with rheumatic conditions

  • Validated screening instruments can be used to identify patients at risk for long-term impairment in physical and psychological functioning

  • Stress-management and other resilience interventions can improve patients' long-term functioning, and seem to be especially useful when tailored to the specific risk and resilience factors of individual patients

  • Innovative approaches to service delivery, including internet applications such as eHealth, promise to increase the efficiency and availability of treatments, and to optimize patient empowerment in rheumatic conditions

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Figure 1: Biopsychosocial stress–vulnerability and resilience model of rheumatic conditions.

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All authors contributed equally to researching data, discussing content and writing the article, and reviewing/editing of the manuscript before submission.

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Evers, A., Zautra, A. & Thieme, K. Stress and resilience in rheumatic diseases: a review and glimpse into the future. Nat Rev Rheumatol 7, 409–415 (2011). https://doi.org/10.1038/nrrheum.2011.80

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