To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA). This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996–2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level. Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74–1.16), 12 (OR 0.96, 95%CI 0.75–1.23), or 60 (OR 0.89, 95%CI 0.72–1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54–1.31), 12 (OR 0.81, 95%CI 0.56–1.16), or 60 (OR 1.37, 95%CI 0.94–2.01) months. In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.

中文翻译：

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低社会支持和低工作决策自由度都与类风湿性关节炎患者的疾病缓解无关：瑞典 EIRA 研究的结果

调查类风湿关节炎 (RA) 患者在 3、12 和 60 个月时的社会心理脆弱性（定义为低社会支持或低工作决策自由度）与疾病缓解之间的关联。该队列研究包括参加 1996-2015 年瑞典类风湿关节炎流行病学调查 (EIRA) 和瑞典风湿病质量登记 (SRQ, n = 2820) 的所有患者。从 EIRA 问卷中确定了关于 RA 诊断工作中的社会支持和决策自由度的信息。根据问卷分别计算社会支持水平和工作决策自由度的指数。工作中的低社会支持和低决策自由度分别由最低四分位数的分数确定，并与其他三个四分位数（不低）进行比较。在 3、12 和 60 个月时从 SRQ 检索疾病活动参数。使用针对年龄、性别、吸烟习惯、饮酒习惯、症状调整的逻辑回归模型分析了工作中的社会支持或决策自由度与疾病活动评分 28 联合计数与 C 反应蛋白 (DAS28-CRP) 缓解之间的关联持续时间和受教育程度。社会支持低 (n = 591) 与 DAS28-CRP 在 3 (OR 0.93, 95% CI 0.74–1.16)、12 (OR 0.96, 95% CI 0.75–1.23) 或 60 (OR 0.89, 95%CI 0.72–1.10) 个月，而社会支持不低 (n = 2209)。没有观察到低 (n = 212) 与不低 (n = 635) 工作决策自由度和 DAS28-CRP 在 3 (OR 0.84, 95%CI 0.54–1.31)、12 (OR 0.81, 95%CI) 缓解的关联0.56–1.16) 或 60 (OR 1.37, 95%CI 0.94–2.01) 个月。