Life events before the onset of rheumatoid arthritis.

All female patients seen at a rheumatological clinic within 1 year of the onset of rheumatoid arthritis were referred for psychiatric assessment. There was 1 refusal and 22 patients were seen by the author, a psychiatrist working in the Department of Rheumatology. Psychiatric assessment, combined with a brief survey of important life events in the year before the onset of symptoms, was compared with a similar assessment made on randomly selected age-matched well women, among whom there was also 1 refusal. 12 of the patients and 5 controls (p = 0.03) reported a bad relationship in childhood with their mothers. 15 patients reported life events in the year before the onset of the arthritis, compared to 8 controls in the matching year (p = 0.03). In 12 of these 15 patients and 3 of the controls the events were assessed as carrying moderate or considerable long-term emotional threat (p = 0.005). In 11 of these 12 patients the interval between the event and the onset was less than 3 months.