Background/Purpose: Traditional clinical measures are well established in idiopathic inflammatory myopathies (IIM), yet exploration of subjective well-being (SWB) remains limited. SWB assessment facilitates holistic patient care and development of targeted interventions. The Satisfaction with Life Scale (SWLS), a validated tool, evaluates the cognitive aspect of well-being, offering valuable insight into patient experience. This study aimed to identify factors associated with SWB in IIM.

Methods: Patient-reported data were collected from a cross-sectional global “Collating the voice of people living with autoimmune diseases” survey covering 111 countries. SWB was assessed using SWLS, categorized as “extremely dissatisfied” (score 5-9) to “extremely satisfied” (score 30-35). We assessed socio-demographic characteristics, disease constructs and psychological constructs [Fig. 1A]. Multivariable regression analysis was performed with SWLS as the dependent variable. Cluster analysis performed using K-means algorithm after proper standardization.

Results: Data from 11,849 participants (IIM=1,252, oRMDs (Other rheumatic and musculoskeletal diseases)=6,653, nrAIDs (non-rheumatic autoimmune diseases)=997, non-autoimmune chronic diseases (CD)=973, healthy population (HC)=1,974) revealed significant differences [Fig.1B] [Table 1] . After adjusting for age, gender, income and education, SWLS scores were lowest in IIM with a median of 17 [Fig 1C,1D] with no significant differences between IIM subtypes.In multivariable regression, psychological (self-efficacy β=0.15, p < 0.001, better mental health β=1.93, p < 0.001), and social factors (job satisfaction β=0.50, p < 0.001, and family functioning β=0.80, p < 0.001) were the strongest positive predictors of SWB. Disease-related factors like damage (β= -0.60, p < 0.001), fatigue (β= -0.48, p = 0.003), pain (β= -0.45, p = 0.001), and depression/anxiety (β= -1.83, p < 0.05) were negatively associated. Lower income (β=-3.4 to -8.8, p < 0.001) and loneliness (β=-0.99, p < 0.001) also predicted lower SWB [Fig. 2A]. Age, disease activity and duration, and comorbidities were not significant in fully adjusted models.K-means clustering of 851 individuals with myositis identified three distinct SWB profiles: high (24%), moderate (49%), and low (27%). High SWB was associated with better mental health, self-efficacy, and family functioning, alongside lower fatigue, pain, and loneliness, whereas the low SWB cluster exhibited significantly worse scores across these domains [Fig.2B]. Subtype-specific patterns emerged: anti-synthetase syndrome (ASyS) predominantly clustered in moderate SWB, polymyositis (PM) in low SWB, and inclusion body myositis (IBM) in both high and low SWB clusters, underscoring heterogeneous psychosocial burden across IIM subtypes.

Conclusion: Our findings show that SWB in IIM is shaped more by psychosocial than clinical factors. Low median SWLS scores highlight the impact of IIM on life satisfaction. Despite similar disease profiles, distinct well-being clusters reveal underlying psychosocial burdens advocating for integrating holistic and person-centered care into rheumatology practice to enhance quality of life.

Fig 1: A- Thematic constructs of variables of interest; B- Flowchart depicting inclusion of participant responses; C- Box plot of Satisfaction with life scale (SWLS) score across groups; D- Heat map demonstrating scores for sub questions of SWLS across various groups.

Fig.2: A- Forest plot of variables statistically significant in regression analysis for SWB; B- Radar chart showing various clusters with characteristics.

Table 1: Baseline descriptive data across groups

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/psychosocial-factors-strongly-influence-subjective-well-being-in-patients-with-idiopathic-inflammatory-myopathies/