title: Psychological and somatic predictors of perceived and measured ocular dryness of patients with primary Sjögren's syndrome.
abstract: OBJECTIVE
  To test if age, disease activity, pain, fatigue, and depression are associated with subjective and objective ocular dryness of patients with primary Sjögren's syndrome (pSS).
  
  
  METHODS
  Sixty female patients with pSS and 60 age matched healthy controls filled out visual analog scale (VAS) scores of ocular dryness and pain, and questionnaires regarding fatigue (Multidimensional Fatigue Inventory) and depression (Zung). Lacrimal tear production was measured by Schirmer I test. As surrogate indicators of disease activity the erythrocyte sedimentation rate, hemoglobin concentration, and total serum immunoglobulin G were determined.
  
  
  RESULTS
  Perceived ocular sicca symptoms were not related to Schirmer I test scores. The rate of tear production was related to age (r = -0.47, p < 0.001), disease activity (r = -0.27, p < 0.05), and pain (r = 0.42, p < 0.001). Age and pain together explained 42% of the variance of the Schirmer I test results.
  
  
  CONCLUSIONS
  Not unexpectedly, age and disease activity were associated with ocular dryness, but contrary to expectation, pain was associated with more instead of less tear production. We did not find evidence that pain, fatigue, or depression are associated with reduced tear production or perceived ocular dryness.
authors.affiliation: Department of Health Psychology, Utrecht University, The Netherlands.
authors.forename: Johanna E
authors.initials: JE
authors.lastname: Vriezekolk
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
authors.forename: André
authors.initials: A
authors.lastname: Hartkamp
authors.forename: Guido L R
authors.initials: GL
authors.lastname: Godaert
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
authors.forename: Aike A
authors.initials: AA
authors.lastname: Kruize
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Ronald H W M
authors.initials: RH
authors.lastname: Derksen
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D015352:Dry Eye Syndromes / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012859:Sjogren's Syndrome / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D013666:Tears / Q000378:metabolism
chemical_list: D015415:Biomarkers