A stress-vulnerability model of depression was investigated in patients with rheumatoid arthritis (RA). Antonovsky's Sense of Coherence (SOC) was examined as a factor protecting against depression.
Relationships between sociodemographic factors, disease activity, functional impairment, pain, depression, and SOC were assessed using multivariate methods in a cross sectional sample of 89 consecutive outpatients with RA.
Increased prevalence of depression was associated with low SOC and high self-rated pain levels, but not with other factors assessed. By multiple regression analysis, independent contributions to depression were observed for SOC (23% of variance) and for pain (24% of variance), but not functional impairment or disease activity.
Comprehensive models of adjustment in RA need to include protective factors such as SOC, in addition to pain and other pathological variables. SOC may be helpful in identifying individuals with RA who are particularly vulnerable to depression, who may be helped by focused psychological interventions such as cognitive therapy.