title: Disease status predicts fatigue in systemic lupus erythematosus.
abstract: OBJECTIVE
  To investigate the relative contributions of disease status, helplessness, and depression to fatigue in patients with systemic lupus erythematosus (SLE) in a path-analytic framework.
  
  
  METHODS
  The disease status of 81 patients with SLE was evaluated by a clinical rheumatologist using the Systemic Lupus Activity Measure. Patients completed self-report measures of psychosocial data, depression, helplessness, and fatigue at 2 assessment periods, 3 months apart. SLE diagnoses were confirmed with patients' physicians.
  
  
  RESULTS
  The model proposed that SLE disease status would predict fatigue directly, and indirectly, through helplessness and depression. At Time 1, disease status, helplessness, and depression were significantly correlated with each other and with fatigue, with helplessness and depression partially mediating the relationship between disease status and fatigue. Longitudinal analyses showed that disease status at Time 1 predicted fatigue, regardless of helplessness and depression operating as mediators at either Time 1 or Time 2.
  
  
  CONCLUSIONS
  The cross sectional findings revealed direct and indirect relationships between disease status and fatigue, with helplessness and depression as mediating variables. However, disease status was the only predictor of fatigue over time. Disease status also predicted Time 2 helplessness, which, in turn, was associated with Time 2 depression. Fatigue amelioration may be an important result of successful management of the underlying SLE process.
authors.affiliation: California School of Professional Psychology, San Diego, at Alliant University, 92121-3725, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Tayer
authors.forename: P M
authors.initials: PM
authors.lastname: Nicassio
authors.forename: M H
authors.initials: MH
authors.lastname: Weisman
authors.forename: C
authors.initials: C
authors.lastname: Schuman
authors.forename: J
authors.initials: J
authors.lastname: Daly
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D018450:Disease Progression; D005221:Fatigue / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D011584:Psychology; D011788:Quality of Life; D012044:Regression Analysis; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012803:Sick Role