Medline ® Abstracts for References 1,2
of 'Overview of the clinical manifestations of systemic lupus erythematosus in adults'
The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus. A proposed model.
McKinley PS, Ouellette SC, Winkel GH
Arthritis Rheum. 1995;38(6):826.
OBJECTIVE: This study describes lupus fatigue multidimensionally and introduces a multivariate model: Sleep problems and depression, through reciprocal effects on each other, act as mediators through which lupus disease activity increases fatigue.
METHODS: Self-reported sleep patterns, depression, and fatigue were assessed in 48 women with systemic lupus erythematosus (SLE) and 27 women from the general population. Rheumatologists rated current lupus disease activity.
RESULTS: The SLE group reported greater overall fatigue than did the controls. Temporal and affective dimensions of fatigue were more differentiating than sensory or severity dimensions. The SLE group also reported longer sleep latency and total sleep time, but not higher depression. Using 2-stage regression, a form of structural equation modeling, the proposed lupus fatigue model was supported.
CONCLUSION: These preliminary results describe fatigue as a multidimensional phenomenon arising out of several contributing factors. They suggest that fatigue treatment strategies should address mediating processes such as sleep and depression, in addition to disease activity.
Graduate Center of the City University of New York, NY 10036, USA.
The prevalence and associations of fatigue in systemic lupus erythematosus.
Tench CM, McCurdie I, White PD, D'Cruz DP
Rheumatology (Oxford). 2000;39(11):1249.
OBJECTIVE: This study assessed the prevalence and associations of fatigue in systemic lupus erythematosus (SLE).
METHODS: Questionnaires were used to measure self-reported fatigue, disease activity, sleep quality, quality of life, anxiety and depression in 120 out-patients with SLE.
RESULTS: Abnormal fatigue was reported by 97 (81%) patients, and 71 (60%) patients reported poor sleep quality. Fatigue correlated negatively with all measures of functioning. Fatigue scores were up to 33% higher in patients with active disease [Systemic Lupus Activity Measure (SLAM>/=3)]than in patients with inactive disease (SLAM>3) (P:<0.05). There were significant correlations between fatigue and disease activity, sleep quality, anxiety and depression.
CONCLUSION: Fatigue is a common complaint of patients with SLE and is associated with diminished ability to function. Apart from treating the primary disease, it may also be worthwhile to treat mood disordersand insomnia in order to reduce fatigue and improve quality of life.
Bone and Joint Research Unit and. Department of Psychological Medicine, St Bartholomew's and The Royal London School of Medicine and Dentistry, London, UK.