Prevalence, severity, and predictors of fatigue in subjects with primary Sjögren's syndrome

Barbara Segal, William Thomas, Tyson Rogers, Joanlise M. Leon, Pamela Hughes, Danielle Patel, Ketan Patel, Jill Novitzke, Michael Rohrer, Rajaram Gopalakrishnan, Sandra Myers, Abu Nasir Mohammad Nazmul Hossain, Eshrat Emamian, Andrew Huang, Nelson Rhodus, Kathy Moser

Research output: Contribution to journalArticle

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Abstract

Objective. To investigate the relationship of fatigue severity to other clinical features in primary Sjögren's syndrome (SS) and to identify factors contributing to the physical and mental aspects of fatigue. Methods. We identified 94 subjects who met the American-European Consensus Group criteria for the classification of primary SS. Fatigue was assessed with a visual analog scale, the Fatigue Severity Scale (FSS), and the Profile of Fatigue (ProF). Associations with fatigue were compared using multivariate regression. Results. Abnormal fatigue, defined as an FSS score ≥4, was present in 67% of the subjects. Pain, helplessness, and depression were the strongest predictors of fatigue according to the FSS and the somatic fatigue domain of the ProF (ProF-S), both with and without adjustment for physiologic and serologic characteristics. Depression was associated with higher levels of fatigue; however, the majority of subjects with abnormal fatigue were not depressed. Anti-Ro/SSA-positive subjects were no more likely to report fatigue than seronegative subjects. The regression models explained 62% of the variance in FSS and 78% of the variance in ProF-S scores. Mental fatigue was correlated with depression and helplessness, but the model predicted only 54% of the variance in mental fatigue scores. Conclusion. Psychosocial variables are determinants of fatigue, but only partially account for it. Although fatigue is associated with depression, depression is not the primary cause of fatigue in primary SS. Investigation of the pathophysiologic correlates of physical and mental aspects of fatigue is needed to guide the development of more effective interventions.

Original languageEnglish (US)
Pages (from-to)1780-1787
Number of pages8
JournalArthritis Care and Research
Volume59
Issue number12
DOIs
StatePublished - Dec 15 2008

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Fatigue
Mental Fatigue
Depression
Visual Analog Scale

ASJC Scopus subject areas

  • Rheumatology

Cite this

Segal, B., Thomas, W., Rogers, T., Leon, J. M., Hughes, P., Patel, D., ... Moser, K. (2008). Prevalence, severity, and predictors of fatigue in subjects with primary Sjögren's syndrome. Arthritis Care and Research, 59(12), 1780-1787. https://doi.org/10.1002/art.24311

Prevalence, severity, and predictors of fatigue in subjects with primary Sjögren's syndrome. / Segal, Barbara; Thomas, William; Rogers, Tyson; Leon, Joanlise M.; Hughes, Pamela; Patel, Danielle; Patel, Ketan; Novitzke, Jill; Rohrer, Michael; Gopalakrishnan, Rajaram; Myers, Sandra; Nazmul Hossain, Abu Nasir Mohammad; Emamian, Eshrat; Huang, Andrew; Rhodus, Nelson; Moser, Kathy.

In: Arthritis Care and Research, Vol. 59, No. 12, 15.12.2008, p. 1780-1787.

Research output: Contribution to journalArticle

Segal, B, Thomas, W, Rogers, T, Leon, JM, Hughes, P, Patel, D, Patel, K, Novitzke, J, Rohrer, M, Gopalakrishnan, R, Myers, S, Nazmul Hossain, ANM, Emamian, E, Huang, A, Rhodus, N & Moser, K 2008, 'Prevalence, severity, and predictors of fatigue in subjects with primary Sjögren's syndrome', Arthritis Care and Research, vol. 59, no. 12, pp. 1780-1787. https://doi.org/10.1002/art.24311
Segal, Barbara ; Thomas, William ; Rogers, Tyson ; Leon, Joanlise M. ; Hughes, Pamela ; Patel, Danielle ; Patel, Ketan ; Novitzke, Jill ; Rohrer, Michael ; Gopalakrishnan, Rajaram ; Myers, Sandra ; Nazmul Hossain, Abu Nasir Mohammad ; Emamian, Eshrat ; Huang, Andrew ; Rhodus, Nelson ; Moser, Kathy. / Prevalence, severity, and predictors of fatigue in subjects with primary Sjögren's syndrome. In: Arthritis Care and Research. 2008 ; Vol. 59, No. 12. pp. 1780-1787.
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abstract = "Objective. To investigate the relationship of fatigue severity to other clinical features in primary Sj{\"o}gren's syndrome (SS) and to identify factors contributing to the physical and mental aspects of fatigue. Methods. We identified 94 subjects who met the American-European Consensus Group criteria for the classification of primary SS. Fatigue was assessed with a visual analog scale, the Fatigue Severity Scale (FSS), and the Profile of Fatigue (ProF). Associations with fatigue were compared using multivariate regression. Results. Abnormal fatigue, defined as an FSS score ≥4, was present in 67{\%} of the subjects. Pain, helplessness, and depression were the strongest predictors of fatigue according to the FSS and the somatic fatigue domain of the ProF (ProF-S), both with and without adjustment for physiologic and serologic characteristics. Depression was associated with higher levels of fatigue; however, the majority of subjects with abnormal fatigue were not depressed. Anti-Ro/SSA-positive subjects were no more likely to report fatigue than seronegative subjects. The regression models explained 62{\%} of the variance in FSS and 78{\%} of the variance in ProF-S scores. Mental fatigue was correlated with depression and helplessness, but the model predicted only 54{\%} of the variance in mental fatigue scores. Conclusion. Psychosocial variables are determinants of fatigue, but only partially account for it. Although fatigue is associated with depression, depression is not the primary cause of fatigue in primary SS. Investigation of the pathophysiologic correlates of physical and mental aspects of fatigue is needed to guide the development of more effective interventions.",
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AU - Thomas, William

AU - Rogers, Tyson

AU - Leon, Joanlise M.

AU - Hughes, Pamela

AU - Patel, Danielle

AU - Patel, Ketan

AU - Novitzke, Jill

AU - Rohrer, Michael

AU - Gopalakrishnan, Rajaram

AU - Myers, Sandra

AU - Nazmul Hossain, Abu Nasir Mohammad

AU - Emamian, Eshrat

AU - Huang, Andrew

AU - Rhodus, Nelson

AU - Moser, Kathy

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N2 - Objective. To investigate the relationship of fatigue severity to other clinical features in primary Sjögren's syndrome (SS) and to identify factors contributing to the physical and mental aspects of fatigue. Methods. We identified 94 subjects who met the American-European Consensus Group criteria for the classification of primary SS. Fatigue was assessed with a visual analog scale, the Fatigue Severity Scale (FSS), and the Profile of Fatigue (ProF). Associations with fatigue were compared using multivariate regression. Results. Abnormal fatigue, defined as an FSS score ≥4, was present in 67% of the subjects. Pain, helplessness, and depression were the strongest predictors of fatigue according to the FSS and the somatic fatigue domain of the ProF (ProF-S), both with and without adjustment for physiologic and serologic characteristics. Depression was associated with higher levels of fatigue; however, the majority of subjects with abnormal fatigue were not depressed. Anti-Ro/SSA-positive subjects were no more likely to report fatigue than seronegative subjects. The regression models explained 62% of the variance in FSS and 78% of the variance in ProF-S scores. Mental fatigue was correlated with depression and helplessness, but the model predicted only 54% of the variance in mental fatigue scores. Conclusion. Psychosocial variables are determinants of fatigue, but only partially account for it. Although fatigue is associated with depression, depression is not the primary cause of fatigue in primary SS. Investigation of the pathophysiologic correlates of physical and mental aspects of fatigue is needed to guide the development of more effective interventions.

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