RESEARCH - Occurrence and correlates of fatigue in psoriatic arthritis

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Ann Rheum Dis. Published Online First: 17 October 2008.

doi:10.1136/ard.2008.098202

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Extended Report

Occurrence and correlates of fatigue in psoriatic arthritis (PsA)

Janice E Husted 1, D Tom 2, T Schentag 3, Vernon T.

Farewell 2 and Dafna D Gladman 4*

1 University of Waterloo, Canada

2 MRC Biostatistics Unit, United Kingdom

3 Toronto Western Hospital, Canada

4 Centre for Prognosis Studies, Canada

Abstract

Objective: To determine the relationship between fatigue and

disease-related and psychosocial variables in PsA.

Method: 499 patients attending the University of Toronto PsA Clinic

were administered the modified Fatigue Severity Scale (mFSS). At the

time of mFSS administration, clinical and laboratory measures of

disease activity and damage were recorded. Linear regression models

were used to examine the cross-sectional relationship between

disease-related and psychosocial variables and mFSS scores.

Results: At least moderate fatigue occurred in 49.5% of patients and

severe fatigue in 28.7%. Univariately the vast majority of variables

were significantly associated with mFSS scores. The final multivariate

model was comprised of female sex, SF-36 pain and mental health

scales, number of fibromyalgia tender points, HAQ and " ever used "

methotrexate and explained 54.5% of the variation in mFSS scores. The

SF-36 mental health scale played the largest role in the multivariate

model, uniquely accounting for 6.6% of the variation in FSS. The

disease-related factors significant at the univariate level did not

achieve statistical significance in the context of HAQ and pain

measures.

Conclusion: Fatigue is a common symptom in PsA, and is associated, in

a multivariate model, with pain, female sex, physical functional

disability, medication status and psychological distress. Fatigue

appears to provide some information that does not overlap with the

core set of outcome domains in PsA.

http://ard.bmj.com/cgi/content/abstract/ard.2008.098202v1?papetoc

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