RESEARCH - Psychosocial variables and fatigue

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J Rheumatol. 2006 Jun 15; [Epub ahead of print]

Psychosocial Variables and Fatigue: A Longitudinal Study Comparing

Individuals with Rheumatoid Arthritis and Healthy Controls.

Mancuso CA, Rincon M, Sayles W, Paget SA.

OBJECTIVE: In individuals with rheumatoid arthritis (RA) and healthy

controls, at enrollment and one year later, we evaluated relationships

between diverse psychosocial characteristics and fatigue in multivariate

analyses. METHODS: Participants with RA and controls completed the Fatigue

Severity Scale (FSS) at enrollment and again after one year. All

participants also completed measures of depressive symptoms, anxiety, role

satisfaction, social support, social stress, disability, physical activity,

and sleep quality at enrollment. RESULTS: A total of 122 individuals with RA

and 122 controls of similar age, sex, education, employment, and marital

status were enrolled. Those with RA had more fatigue compared to controls

(FSS scores 4.2 +/- 1.2 vs 3.4 +/- 1.1; p < 0.0001) (possible range 1-7,

higher score = more fatigue). In cross-sectional multivariate regression

analysis for the RA group, more fatigue was associated with more anxiety,

more disability, less social support, and more social stress (p </= 0.03 for

each variable, R2 = 0.48). In cross-sectional multivariate regression

analysis for controls, more fatigue was associated with more depressive

symptoms and more social stress (p </= 0.003 for each variable, R2 = 0.31).

Repeat FSS scores at one year also were worse for the RA group (n = 91)

compared to controls (n = 89) (4.1 +/- 1.3 vs 3.2 +/- 1.0; p < 0.0001).

However, changes in scores from enrollment to followup were not markedly

different within patients [0.21 for the RA group (p = 0.05) and 0.08 for

controls (p = 0.41)]. Enrollment variables that were associated with worse

fatigue at followup, based on longitudinal multivariate regression analysis,

were less help at home, more anxiety, and more disability for the RA group

(p </= 0.007 for each variable), and more anxiety and less physical activity

for controls (p </= 0.006 for each variable).

CONCLUSION: Fatigue was relatively stable over time and was common in both

the RA group and controls. In addition, fatigue was more closely associated

with psychosocial factors in the RA group, and social stress was identified

as a relatively unexplored potentially modifiable variable independently

related to fatigue in RA.

PMID: 16783859

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6783859

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