Open Access Research article

Experimental stress in inflammatory rheumatic diseases: a review of psychophysiological stress responses

Sabine JM de Brouwer1*, Floris W Kraaimaat1, Fred CGJ Sweep2, Marjonne CW Creemers3, Timothy RDJ Radstake3, Antoinette IM van Laarhoven1, Piet LCM van Riel3 and Andrea WM Evers1

Author Affiliations

1 Department of Medical Psychology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

2 Department of Chemical Endocrinology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

3 Department of Rheumatology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

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Arthritis Research & Therapy 2010, 12:R89  doi:10.1186/ar3016


See related editorial by Hassett and Clauw, http://arthritis-research.com/content/12/3/123

Published: 17 May 2010

Abstract

Introduction

Stressful events are thought to contribute to the aetiology, maintenance and exacerbation of rheumatic diseases. Given the growing interest in acute stress responses and disease, this review investigates the impact of real-life experimental psychosocial, cognitive, exercise and sensory stressors on autonomic, neuroendocrine and immune function in patients with inflammatory rheumatic diseases.

Methods

Databases Medline, PsychINFO, Embase, Cinahl and Pubmed were screened for studies (1985 to 2009) investigating physiological stress responses in inflammatory rheumatic diseases. Eighteen articles met the inclusion criteria.

Results

Results suggest that immune function may be altered in response to a stressor; such alterations could contribute to the maintenance or exacerbation of inflammatory rheumatic diseases during stressful events in daily life.

Conclusions

This review emphasizes the need for more experimental research in rheumatic populations with controlled stress paradigms that include a follow-up with multiple evaluation points, simultaneous assessment of different physiological stress systems, and studying factors contributing to specific physiological responses, such as stress appraisal.