Dimensions of fatigue in systemic lupus erythematosus: relationship to disease status and behavioral and psychosocial factors.
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.
Da Costa
Deborah
D
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
Dritsa
Maria
M
Bernatsky
Sasha
S
Pineau
Christian
C
Ménard
Henri A
HA
Dasgupta
Kaberi
K
Keschani
Anahita
A
Rippen
Natalie
N
Clarke
Ann E
AE
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