Sjögren’s Patients Exhibit Different Personality Traits than Healthy Individuals, Study Suggests

Marisa Wexler MS avatar

by Marisa Wexler MS |

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Pri-Med, medical education

Patients with primary Sjögren’s syndrome may have different personality characteristics, including a tendency to be more neurotic and less extroverted and open to experiences, than healthy individuals, a study reports.

The study, “Personality, depression and anxiety in primary Sjogren’s syndrome — Association with sociodemographic factors and comorbidity,” was published in PLOS ONE.

As in all chronic diseases, the relationship between the disease state and personality is complex and bidirectional, likely influenced by a host of interconnected factors, including genetic and environmental differences.

For example, more stress can activate inflammatory pathways, which might make some people more likely to develop autoimmune disorders — although living with an autoimmune disorder might also make a person more stressed.

Regardless of causality, understanding the psychological profiles of patients with chronic diseases might help ensure that patients receive optimum care so that they can maintain the best quality of life possible.

To take a look at this, the researchers recruited 105 patients with primary Sjögren’s syndrome as well as 52 patients with rheumatoid arthritis and 54 healthy individuals for comparison. All the patients were females treated at a university hospital in Serbia.

Patients were assessed for various personality traits using the “big five” or five-factor model. Personality is, of course, highly complicated and difficult to measure quantitatively.

This model has proven to be fairly reliable and consistent, assessing patients based on five overarching personality traits: neuroticism (which reflects a person’s emotional stability and how he or she deals with stress), extraversion (how a person interacts with others and responds to positive emotions), openness to experience (a person’s willingness to try new things and be creative and imaginative), agreeableness (ability to be compassionate and cooperative toward others), and conscientiousness (related to self-discipline and impulse control).

Patients were also screened for symptoms of anxiety and depression using a separate assessment.

Compared with healthy people, Sjögren’s patients had higher scores for neuroticism and lower scores for extraversion and openness to experience. This was similar to the results found for rheumatoid arthritis patients. Sjögren’s patients also had higher anxiety scores than healthy individuals, although there was no significant difference in terms of depression.

Further analysis of the sociodemographic background of patients suggested that education and satisfaction with family relationships were better predictors of patients’ psychological profiles than disease status.

“We confirmed that pSS [primary Sjögren’s syndrome] patients have psychological profiles and levels of anxiety different to healthy subjects,” the researchers said. “In our study, patients with pSS were emotionally unstable, introverted, and more anxious than healthy controls.”

“Education and satisfaction with family relationships predisposed to their psychological profile. Psychological assessment of patients with pSS may improve understanding and treatment of this clinical condition,” they added.

However, there are some important notes of caution to this conclusion. First and foremost, analysis of psychological traits is imprecise at best; for example, the investigators note that “neuroticism is clinically heterogeneous and diagnostically nonspecific and could be present in neurotic disorders, but also in psychotic and affective disorders or in healthy persons.”

Additionally, this study only included a relatively small number of female patients living in Serbia, so care should be taken in extrapolating these results.


Janette L Dombrowski avatar

Janette L Dombrowski

While I think studies like this are very important to understanding and treating this disease I cringe when I read about such small studies in another culture and study model. The cautions about interpretation at the end of the article are easily overlooked and a misrepresentation of outcome is prevalent. Too often Drs see this before test results and diagnoses and treatment are geared to a neurotic hypersensitive patient rather than an ill patient. I'm afraid, like people with fibromyalgia, people with Sjogren's will be prescribed anti depression medications and be blamed for their own illness.

Suzie avatar


This type of study only makes sense if you do a personality survey before and after someone develops a chronic health issue. For example, because of my Sjogren's undertaking a new activity, like attending a sporting event at a place I haven't been before, requires a great deal of research and planning. Are the seats relatively accessible? How many stairs might I have to climb? How far are the restrooms from my seat? Will I have to stand in line to enter, or is there accommodation for people using wheelchairs or mobility scooters? What the situation about sun? Will I be in full sun during part of the event? Can I bring my own water, or do I have to purchase it there?

These are just basic planning activities to deal with my fatigue, needs to sip water, avoid a lot climbing and standing, and avoid sun. The consequences of not planning for these details could be a couple of days in bed. To someone without these disabilities, it could seem neurotic, or unwillingness to try new things. To someone who deals with these problems, it's business as usual.

I wasn't like this before I got sick. So without the before and after comparison, I don't see how it's a relevant measure.

Linda Kwiatkowski avatar

Linda Kwiatkowski

I agree with the other comments. I'm not sure of the education level of these researchers, but it is clear that they don't have enough insight into the disease process of Sjogren's Syndrome, as well as how people have to adapt to disability and disease. Articles such as this really just further stigmatize patients with autoimmune disease as being at blame due to different behavior, and then try to associate a medical, autoimmune disease with psychiatric disorders and poor coping skills. The one thing it may prove is that having a bad disease impacts quality of life in a negative way, because everything has to change to deal with the disease. Don't forget to be (compassionate and understanding, cooperative toward others), agreeableness.

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