Definition
Rheumatoid arthritis is a chronic inflammatory systemic disease. Typical of rheumatoid arthritis is that it mostly affects joints and causes joint inflammation in at least five different joints in the body. This clinical picture is known as “polyarthritis“. The inflammation proceeds in recurrent attacks and the destruction in the joint is permanently progressive. According to current research, the destruction of the joint cannot be reversed and can only be slowed down therapeutically.
Pathogenesis of rheumatoid arthritis
Rheumatoid arthritis is a multifactorial disease. This means that several triggers work together to ultimately trigger the autoimmune disease. There is no direct inheritance of the disease, but there is evidence that individual genes that are inherited are associated with the onset of the disease.
Only when several of these genes appear together is the risk of the disease increased, but an outbreak is never guaranteed. Neither does the absence of genes mean that one is spared from the disease in any case. Especially noticeable is a connection to the so-called HLA-complexes, which are genes that play an essential role in the immune system (e.g. also in organ transplants).
Variations of the HLA genes are suspected to promote inflammatory rheumatic diseases. Variations of genes for certain regulatory proteins (cytokines) and other immune modulators are also associated with rheumatoid arthritis. The figures for actual heritability in the case of genetic abnormalities vary from study to study. It is assumed that the risk of developing the disease in first-degree relatives approximately triples.
Psychological causes of rheumatoid arthritis
It is noticeable that rheumatoid arthritis is closely related to psychological factors and emotional states of affect. Many patients develop such an autoimmune disease after the loss of a loved one, a case of illness in the family but also after phases of great emotions such as grief and anger. The physical consequence of the joint inflammation brings an almost relieving pain, which makes one forget the emotional situation.
Just like the psychological factors that trigger rheumatoid arthritis, an effect on the course of the disease can also be observed. A passive attitude to the disease has a negative effect, whereas recognition and conscious fighting against the disease can promote clear treatment successes. Rheumatoid arthritis is one of the seven psychosomatoses.
These are physical illnesses that can be triggered by psychological stress. Stress also represents a straining psychological condition, which can favor a Rheumatoide Arthritis. Studies have shown that stress not only increases the probability of onset, but also worsens the inflammation, intensifies the symptoms and promotes new relapses of the disease.
It should be noted that a persistent level of stress in particular influences health, less frequently the major stress factors, such as severe life events. Psychological care and treatment is particularly important for rheumatism patients. It offers great additional help to drug therapy and can actively improve symptoms and course of the disease.
