[Rheumatism and the mind-A mini review]

Abstract

Background: Rheumatic and mental disorders are common and affect each other. The comorbidities are often diagnosed too late or not at all but cause considerable suffering for those affected and have a negative effect on the health-related quality of life and therapeutic success.

Objectives: Is there any evidence regarding common pathophysiological mechanisms and how can they be considered in terms of therapy?

Methods: Recent findings, reviews and basic literature are analyzed and an update is presented and discussed.

Results: The current data suggest a mutual influence of the factors stress and inflammation both in depressive disorders, anxiety disorders and chronic pain, as well as in diseases of the rheumatic type. There is a close relationship between immunological and neuronal processes that bi-directionally regulate the individual's stress response.

Conclusions: For sufficient therapy the establishment of an interdisciplinary treatment concept in clinical everyday life is to be striven for. In addition to rheumatic treatment, this should include a multimodal approach to both pharmacological and psycho-socio-therapeutic components. In particular, potential interactions must be taken into account.

Keywords: Antidepressants; Anxiety disorders; Chronic pain; Depression; Inflammation.