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Psychobiological variables in the onset and recurrence of gouty arthritis: A chronic disease model

1975; Pergamon Press; Volume: 28; Issue: 1 Linguagem: Inglês

10.1016/0021-9681(75)90048-x

1878-0679

Jack L. Katz, Herbert Weiner, Ts’ai-Fan Yű,

Hepatitis C virus research

Sixteen men, all with documented gout, were interviewed in depth toward the goal of elucidating dietary, medical, social, psychological, and behavioral events that were associated with arthritic episodes. All 16 reported that some of their attacks ‘came out of the blue’ but that other attacks seemed to have definite and reliable precipitants. The most commonly described precipitants included alcohol and dietary indiscretion, local joint trauma, surgery and infection, not taking prescribed medication, and life experiences that were usually associated with feelings of tense anticipation. However, the last of these was also commonly associated with several of the other precipitants, whose mechanisms for triggering an acute arthritis are generally definable. Whether there is a specific affect, such as tense anticipation, which is most likely to trigger an attack, perhaps even independently of any concomitant behavioral variables, is not clear; however, catecholamine and hydrocortisone release, which can accompany such emotional arousal, could be mediating variables. The variety of precipitants described, operating via different mechanisms to aggravate the underlying metabolic abnormality, compromise compensatory reserve, or set off local changes which provide a milieu favorable to the disease's expression, hopefully provide some insight into why chronic diseases tend to run such variable courses between and within patients.