Psychological Stress and Anxiety in Autoimmune Diseases: A Cross-Sectional Case-Control Study.

Background

Psychological distress has been frequently reported in individual autoimmune diseases, but evidence regarding shared psychological characteristics across heterogeneous autoimmune conditions remains limited.

Objective

This study compared stress vulnerability, exposure to major life events, state and trait anxiety, and Type A behavioral characteristics between adults with autoimmune diseases and controls.

Methods

This cross-sectional case-control study included 389 adults: 204 patients with autoimmune diseases and 185 controls. Participants completed the Stress Vulnerability Scale, Holmes-Rahe Life Stress Inventory, State-Trait Anxiety Inventory, and Jenkins Activity Survey. Between-group differences, effect sizes, and correlations among psychometric variables were examined.

Results

Patients with autoimmune diseases had significantly higher stress vulnerability scores (Cohen's d = 0.39) and Holmes-Rahe life-event burden (d = 0.54) than controls. State anxiety (d = 0.52) and trait anxiety (d = 0.68) were also higher (all p < 0.001). Type A behavioral characteristics did not differ significantly between groups. State and trait anxiety showed the strongest correlation (r = 0.755, p < 0.001). Disease duration was positively associated with Holmes-Rahe scores but not with stress vulnerability or anxiety.

Conclusions

Adults with autoimmune diseases showed a higher psychological burden across several complementary psychometric dimensions. These findings support consideration of psychological screening within multidisciplinary autoimmune disease care. Longitudinal and disease-specific studies integrating biological, psychological, and social factors are required to clarify temporal and potentially bidirectional relationships.