Stress, depression, and pain are the largest independent contributors to fatigue among patients with systemic lupus erythematosus (SLE), without concurrent fibromyalgia (FM), according to a recent study. Disease activity, sleep, and physical health were not associated with fatigue, however. Therefore, the evaluation of stress, depression, and pain needs to be incorporated during assessments and clinical trials of individuals with SLE, especially within fatigue. A total of 116 ethnically diverse, primarily female participants (91%) with SLE, receiving care at university medical centers, completed assessments of disease activity and quality of life outcomes. Researchers found:
- Mean (SD) age was 39.80 (13.87) years; 50% were African American, 21% Caucasian, 13% Hispanic, 9% Asian and 8% other.
- In the multivariate model, depression, stress, and pain were significantly and independently associated with fatigue, but not disease activity, sleep, or physical health.
- Stress had the largest effect on fatigue, followed by depression.
- On stepwise regression analysis, only stress, depression, and pain were retained in the model, and collectively explained 56% of the variance in fatigue.
- All 3 remained independent correlates of fatigue, with the largest contribution being stress, followed by depression with fatigue.
Azizoddin DR, Gandhi N, Weinberg S, Sengupta M, Nicassio PM. Fatigue in systemic lupus: The role of disease activity and its correlates. [Published online ahead of print December 22, 2018]. Lupus. doi:10.1177%2F0961203318817826.