The relationship between disease-related fear, quality of life, and psychological status in patients with rheumatoid arthritis

Aim: Rheumatoid arthritis (RA) causes inflammation, disability, and psychosocial burden. Patients often experience anxiety, depression, and disease-related fears, which may affect quality of life (QoL) and treatment adherence. This study examined the relationship between disease activity, psychological status, QoL, and disease-related fear using the Fear Assessment in Inflammatory Rheumatic Diseases (FAIR) questionnaire. Materials and Methods: Thirty-four patients with RA were included. Disease activity was assessed with the Disease Activity Score 28 (DAS28), pain with the Visual Analogue Scale (VAS), psychological status with the Hospital Anxiety and Depression Scale (HADS), and functional status with the Health Assessment Questionnaire (HAQ). QoL was measured using the Short Form-36 (SF-36), and fear levels were assessed with the FAIR questionnaire. Data were analyzed statistically. Results: The majority of participants were female (91.2%). The mean DAS28 was 3.50 ± 1.18, and the mean VAS score was 46.68 ± 29.14, showing a significant correlation (r = 0.507, p = 0.002). Mean HADS-anxiety and HADS-depression scores were 8.8 ± 4.24 and 8.0 ± 4.80, respectively, and were positively correlated (r = 0.475, p = 0.005), but neither correlated with DAS28. Within the SF-36, Bodily Pain (BP) and Role Emotional (RE) domains correlated negatively with DAS28 (r = –0.52 and –0.43). Vitality, General Health, and Mental Health domains correlated negatively with HADS-depression (r = –0.62, –0.58, –0.38). The mean FAIR score was 61.4 ± 21.3, correlating with VAS (r = 0.347, p = 0.044) and borderline with HADS-anxiety (r = 0.33, p = 0.054), but not with DAS28, treatment type, or age. Conclusion: In RA, disease activity was associated with pain and selected QoL domains, while disease-related fear was more strongly linked to subjective pain and anxiety than to objective inflammatory activity. Addressing psychological factors alongside disease control may improve patient outcomes.