Comprehensive care and psycho-social factors in rehabilitation in chronic rheumatoid arthritis: a controlled study.

Abstract A controlled study of comprehensive care in ambulatory patients with severe rheumatoid arthritis was carried out to determine the interrelationships between intensity of care, psycho-social factors and functional benefits. Psycho-social factors did not appear to influence disease activity. Results suggest that patients with higher intelligence scores more often maintain functional performance and improve in social adjustment than do patients with low intelligence scores. The more intelligent patients also had better motivation for rehabilitation. Improved social adjustment was more often seen in the intensive treatment group. A combination of good motivation and intensive treatment appeared to favor the achievement of superior functional results as judged by ADL performance. Furthermore, the patients showing better ADL function after 1 yr improved more in social adjustment. The results suggest that psycho-social factors, although they do not alter rheumatoid disease activity, can affect functional results of rehabilitation measures.