Coping strategies, emotional distress and perceived disease severity in a cohort of patients with rheumatoid arthritis: a mediation analysis.

This article investigates the relationship between specific coping strategies and the Patient Global Assessment (PGA) of disease severity in rheumatoid arthritis (RA) patients, focusing on the mediating role of emotional distress measured by the Hospital Anxiety and Depression Scale (HADS). In a cohort of 490 RA patients, emotional distress significantly mediated the effect of four coping strategies—religious coping, planning, behavioral disengagement, and focus on and venting of emotions—on PGA scores. Seven other coping strategies, including acceptance and active coping, were directly associated with PGA without mediation by emotional distress. The findings suggest that psychological interventions targeting maladaptive coping styles and emotional distress may help reduce patients' perceived disease severity, highlighting the importance of integrating psychological assessment and support in RA management.