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Mental health needs of people with autoimmune disease during a pandemic

Mental health needs of people with autoimmune disease during a pandemic

Why this research matters

Like physical health, mental health is a part of everyone's life. Our mental health determines how we interact with the world and deal with challenges. It’s important to be proactive in learning about mental health and developing coping skills before we find ourselves in a crisis. This is especially true if we have a chronic illness like arthritis.

What is this research about? 

While arthritis compromises physical health, its impact does not stop there. Canadians with arthritis are nearly twice as likely to have a mood disorder like depression compared to those without arthritis. They’re also 1.5 times as likely to have an anxiety disorder. Many Canadians are reporting worsening mental health since the pandemic began. How is the global pandemic impacting the mental health of people already living with the challenges of arthritis?

What did the researchers do? Photography of Dr. Kathleen Bingham

Drs. Kathleen Bingham and Zahi Touma and their team reviewed published literature and media reports to determine which factors contribute to mental health challenges in people with autoimmune disease. They also explored existing mental health interventions developed for use in COVID‐19 and for people with autoimmune disorders.

What did they find?  

Photography of Dr. Zahi ToumaThe factors that contribute to psychological distress in people with autoimmune disease during the pandemic include feelings of discrimination related to downplaying of COVID-19 among healthy people, a sense that the lives of individuals with chronic illness are viewed as less valuable than those of other members of the population, fear of infection, uncertainty related to the availability of medications, less access to usual care and resources, previous healthcare experience, and the impact of social isolation.

While many people with autoimmune disease are uniquely equipped to manage COVID‐19–related stressors because of previous experience practicing infection control and coping with isolation due to illness or effects of treatment, this is not the case for all people with autoimmune disease. It is critical that mental health needs are addressed along with physical needs to provide high-quality person-centred care to all people.

What is the impact of this research?

Understanding factors that contribute to mental health will help clinicians, researchers and people with autoimmune diseases develop strategies to manage challenges during this stressful and uncertain time. Individual strategies may involve controlling consumption of stressful media, maintaining social connections, maintaining a routine that includes adequate sleep and exercise, practicing mindfulness and relaxation, focusing on factors within one’s control and connecting with virtual peer support programs.

Photography of Renee Pordage
Many of my coping strategies for dealing with fear and anxiety, such as support from my medical team and family/friends, were no longer available to me as the pandemic began. I was able to connect with a physiotherapist virtually so that I could modify my exercise routine and continue to be physically active. Yoga and mindfulness combined to keep me in the present and not worry about looking too far in the future. A prescription for medical cannabis helped with getting the necessary sleep. And critical social contact was maintained either through FaceTime or meeting friends outdoors and distanced when weather permitted. "

— Renee Pordage, Arthritis Society Online Consumer Panel Member

About the researcher 

Dr. Zahi Touma is an associate professor in the division of rheumatology at the University of Toronto and a staff physician and clinician scientist at Toronto Western Hospital and Mount Sinai Hospital. His research has been supported in part by an Arthritis Society Young Investigator Operating Grant and Young Investigator Salary Award, awarded in 2015.

Dr. Kathleen Bingham is a staff psychiatrist at the University Health Network Centre for Mental Health and an assistant professor in the department of psychiatry at the University of Toronto. Her research focuses on cognition and everyday functioning in late life and psychotic depression.

Publication citation 

Bingham KS, Rozenbojm N, Chong-East M, Touma Z. Exploring the mental health needs of persons with autoimmune diseases during the coronavirus disease 2019 pandemic: A proposed framework for future research and clinical care. ACR Open Rheumatology. 2021;3(1):25-33.

Research at the Arthritis Society

Through the trust and support of our donors and partners, the Arthritis Society is Canada’s largest charitable funder of cutting-edge arthritis research, investing over $220 million in research projects since our founding. These projects have led to breakthroughs in the diagnosis, treatment and care of people with arthritis. Visit us at