title: History of affective disorder and the temporal trajectory of fatigue in rheumatoid arthritis.
abstract: This study examines whether the general level and rate of change of fatigue over time is different for those rheumatoid arthritis (RA) patients with and those without a history of affective disorder (AD). Four hundred fifteen RA patients from a national panel had yearly telephone interviews to obtain fatigue and distress reports, and a one-time semistructured assessment of the history of depression and generalized anxiety disorder Growth-curve analysis was used to capture variations in initial fatigue levels and changes in fatigue over 7 years for those with and without a history. RA patients with a history of major AD reported levels of fatigue that were 10% higher than those without a history in the 1st year of the study. Their fatigue reports remained elevated over 7 years. Further analysis showed that the effects of a history of AD on fatigue are fully mediated through current distress, although those with a history had a significantly smaller distress-fatigue slope. Thus, a history of AD leaves RA patients at risk for a 7-year trajectory of fatigue that is consistently higher than that of patients without a history. The elevation in fatigue reports is, at least in part, a function of enduring levels of distress.
authors: University of Connecticut School of Medicine, USA.
authors: J
authors: J
authors: Fifield
authors: J
authors: J
authors: McQuillan
authors: H
authors: H
authors: Tennen
authors: T J
authors: TJ
authors: Sheehan
authors: S
authors: S
authors: Reisine
authors: V
authors: V
authors: Hesselbrock
authors: N
authors: N
authors: Rothfield
mesh_terms: D001008:Anxiety Disorders / Q000150:complications*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000523:psychology*; D005221:Fatigue / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications*; D011446:Prospective Studies; D013997:Time Factors