Background: The Fear of (illness-) Progression (FOP) is an essential psychosocial distress and one of the most frequent emotional strains in patients with rheumatic diseases and impairs quality of life.
Objectives: The research project* includes at first the construction of a self-assessment instrument, the FOP-Questionnaire (FOP-Q) and at second a psychological program to FOP Types and extent of FOP in the group of 258 patients with rheumatic diseases (e.g. RA, AS, PSA, SLE, SSc, MCTD, Sjögren syndrome) were compared with two groups of 334 patients with cancer (colon or breast cancer) and 246 patients with diabetes mellitus (type 1 or 2) in six rehabilitations centres.
Methods: 1. project-phase: FOP can be assessed by the FOP-Q (43 items). 2. project-phase: a new developed psychotherapy-treatment-program, based on behavioral-medicine methods was applied to 174 rheumatic patients (46,4 years old on average, SD 9,4; 55% female), external randomized in experimental- and controlgroups.
Results: Demonstrated are further special results of the therapy-evaluation, based on the 3-level-model of anxiety in its behavioral-physiological, cognitive an emotional dimensions.
Described are the most frequent fears (e.g. fear of >side-effects of longterm medication = harmfullness, >loss of functional ability = disability), as soon as forms, contents, expressions of fear and their changes, related to 4 fear-scales (affective reactions, partner/family, work, loss of autonomy) and a coping-scale.
The principal inducer for fear = incidence of restraint mobility

Conclusion: Fear of Progression (FOP) is a high relevant problem for patients with rheumatic diseases, can differentiated in a variety of fear-expressions in intensity, forms, contents and can be reduced by individual learned coping-strategies.
*Supported by the German Federal Ministry for Education and Research (BMBF), the Federation of German Pension Insurance Institutes (VDR) and the Rehabilitation Research Network of Bavaria (RFB).
References: 1. Engst-Hastreiter, U., Duran, G., Henrich, G., Waadt, S., Berg, P. , Herschbach, P. (2006): Fear of Progression (FOP) in Rheumatic Diseases: Psychological Treatment. Rheumatology-Official Journal of the British Society for Rheumatology (BSR), Vol. 45, No. 1, 106-107.
2. Engst-Hastreiter, U., Duran, G., Henrich, G., Waadt, S., Berg, P. , Herschbach, P. (2007): Follow-up of a Psychotherapy-Program to fear of Progression (FOP) in rheumatic diseases. Annals of the Rheumatic Diseases, BMJ Publishing Group and European League Against Rheumatism (EULAR), Vol. 66, No. 11, 574 -575.
3. Engst-Hastreiter, U., Duran, G., Henrich, G., Waadt, S., Berg, P. , Herschbach, P. (2007): Follow-up of a Psychotherapy-Program to fear of Progression (FOP) in rheumatic diseases. International Journal of Rehabilitation Research-official Journal of the European Federation for Research in Rehabilitation (EFRR) Vol. 30, No. 1, 44-45.