title: Dimensions of fatigue in systemic lupus erythematosus: relationship to disease status and behavioral and psychosocial factors.
abstract: OBJECTIVE
  To characterize the experience of fatigue in patients with systemic lupus erythematosus (SLE) using a multidimensional assessment and to delineate contributors to physical and mental dimensions of fatigue.
  
  
  METHODS
  Fatigue in 130 women with SLE was assessed using the Multidimensional Fatigue Inventory (MFI-20). Participants completed standardized questionnaires assessing sleep quality, depressed mood, social support, and leisure-time physical activity. A clinical examination determined disease activity, cumulative damage, and whether patients fulfilled American College of Rheumatology criteria for fibromyalgia (FM). A series of hierarchical multiple regressions were computed to identify contributors to physical and mental fatigue.
  
  
  RESULTS
  Patients scored high on all 5 MFI-20 fatigue dimensions, with general fatigue and physical fatigue having the highest scores. A hierarchical multiple regression showed that greater disease damage and disease activity, the presence of FM, depressed mood, sleep disturbance, and less participation in leisure-time physical activity contributed to higher physical fatigue scores. The results of the second model found depressed mood to be the strongest determinant of mental fatigue. Disease-related variables were not associated with mental fatigue.
  
  
  CONCLUSIONS
  Fatigue in SLE is multidimensional and multidetermined, with physical and mental aspects likely having different etiologies. A multidimensional assessment of fatigue in SLE is needed to tailor and optimize interventions aimed at alleviating fatigue.
authors.affiliation: Division of Clinical Epidemiology, Division of Rheumatology, and Division of Clinical Immunology/Allergy, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada. Deborah.DaCosta@mcgill.ca
authors.forename: Deborah
authors.initials: D
authors.lastname: Da Costa
authors.forename: Maria
authors.initials: M
authors.lastname: Dritsa
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
authors.forename: Christian
authors.initials: C
authors.lastname: Pineau
authors.forename: Henri A
authors.initials: HA
authors.lastname: Ménard
authors.forename: Kaberi
authors.initials: K
authors.lastname: Dasgupta
authors.forename: Anahita
authors.initials: A
authors.lastname: Keschani
authors.forename: Natalie
authors.initials: N
authors.lastname: Rippen
authors.forename: Ann E
authors.initials: AE
authors.lastname: Clarke
mesh_terms: D003866:Depressive Disorder; D005221:Fatigue / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D009440:Neurasthenia / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D011584:Psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D012890:Sleep; D011795:Surveys and Questionnaires