Environmental Epidemiology and Risk Factors for Autoimmune Disease

M. A. Dooley, MD, MPH, S. L. Hogan, PhD, MPH

Disclosures

Curr Opin Rheumatol. 2003;15(2) 

In This Article

Psychosocial Stressors

It has previously been observed that stress from major life events may contribute to the onset of RA.[49] The recent case-control study of RA provides several new insights broadening the scope of psychosocial stress that may contribute to the onset of RA.[16*] In women, "matrimonial quarrels" during the 5-year period preceding the RA symptoms and the 5 years preceding the diagnosis of RA were significantly associated with the onset of RA compared with controls. In men "problems at work" preceding the onset of symptoms and "economic problems" within 5 years of diagnosis of RA were also associated with the onset of RA.

Disparate social environmental factors and medical status have been associated with the onset of autoimmune disorders such as type I diabetes. Psychological mechanisms are directly linked by hormonal and nervous system signals, influencing the need for insulin. Stress has also been shown to modulate immune responses. A population-based study in Sweden[50] recruited 78% of all prospective parents over a 2-year period with 97% completing 1-year follow up data on 4337 children. Evaluation of the potential association of stressors in this population with subsequent development of diabetes in the offspring awaits long-term follow up.

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