Functional ability, social support, and depression in rheumatoid arthritis D.M. Doeglas 1,2 , Th.P.B.M. Suurmeijer 3,4 , W.J.A. van den Heuvel 5 , B. Krol 6 , M.H. van Rijswijk 7 , M.A. van Leeuwen 7 & R. Sanderman 3 1 Department of Psychology, Heymans Institute, University of Groningen; 2 Research Institute for Higher Education (COWOG), University of Groningen (E-mail: dirk@doeglas.nl); 3 Northern Centre for Healthcare Research (NCH), University of Groningen; 4 Interuniversity Centre for Social Science Theory and Methodology (ICS), University of Groningen; 5 Institute for Rehabilitation Research, Hoensbroek; 6 Department of Public Health Sciences, University of Groningen; 7 Department of Rheumatology, University Hospital Groningen, The Netherlands Accepted in revised form 12 August 2003 Abstract Objective: First, to investigate the patterns of functional ability, depressive feelings, and social support in early stage rheumatoid arthritis (RA) patients. Second, to demonstrate the stress buffering effect of social support. Social support is thought to reduce the impact of chronic stress on psychological well-being; for patients without social support the impact of functional ability on depressive feelings will be stronger. Methods: In 4 waves with an intervening period of 1 year, longitudinal data was collected of 264 Dutch RA patients, of which 65% was female. At T1, the mean age of these patients was 53 years, while their mean disease duration was 22 months. In an interview at the patients’ homes, data was collected on functional ability, social support en psychological well-being. The buffering effect of social support was examined by testing the significance of the (computed) stressor by social support interaction term in a regression analysis on depressive feelings. Results: Although large differences between subjects existed, the mean scores on functional ability, social support, and depressive feelings barely changed from year to year. Patients who deteriorated in functional ability during one year had the best chances to improve next year, and visa versa. Furthermore, the stress by support interaction terms had no significant effect on depressive feelings in a regression analysis. Conclusions: This study demonstrated clearly the fluctuating pattern of RA in the first years after onset. The patients’ level of depressive feelings was linearly related to the level of functional ability. Like many other studies, also this study could not provide evidence for the stress buffering effect of social support. Keywords: Buffering effect, Depression, Functional ability, Rheumatoid arthritis, Social support Introduction Like most chronic diseases, rheumatoid arthritis (RA) is characterised by an unknown aetiology and an unknown course and prognosis at the in- dividual level. Particularly in recent onset cohorts, the disease has a highly variable and unpredictable course [1–4]. However, sooner or later, all people with RA will be confronted with the physical consequences of the disease, which lead to a de- crease in functional ability. Because of inflamma- tion of the joints, which is the main characteristic of RA, patients are troubled by pain, stiffness, and lack of energy. As a result of the joints being af- fected, a decrease in functional ability occurs in varying degrees and progression. Subsequently, many difficulties arise in the performance of ac- tivities of daily living, and activities related to Quality of Life Research 13: 1053–1065, 2004. Ó 2004 Kluwer Academic Publishers. Printed in the Netherlands. 1053