EDITORIAL - Fatigue in patients with RA: what is known and what is needed

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Rheumatology Advance Access originally published online on October 16, 2008

Rheumatology 2009 48(3):207-209; doi:10.1093/rheumatology/ken399

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EDITORIALS

Fatigue in patients with rheumatoid arthritis: what is known and what is needed

H. Repping-Wuts1, P. van Riel1 and T. van Achterberg2

1Department of Rheumatology and 2IQ Scientific Institute for Quality

of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen,

The Netherlands

Concept and definition

Fatigue is, just like pain, a subjective symptom which may occur in

patients with many different diseases and thereby also in patients

with RA. In the literature, a consensus definition for fatigue is not

presented. However, most authors define fatigue as: 'an overwhelming,

sustained sense of exhaustion and decreased capacity for physical and

mental work' [1]. For chronic fatigue, Piper's definition is widely

used in international studies and is as follows: 'chronic fatigue is

perceived as unpleasant, unusual, abnormal or excessive whole-body

tiredness, disproportionate to or unrelated to activity or exertion

and present for more than one month. Chronic fatigue is constant or

recurrent, it is not dispelled easily by sleep or rest and it can have

a profound negative impact on the person's quality of life' [2]. To

distinguish between chronic fatigue and the chronic fatigue syndrome

(CFS), the Centre for Disease Control and Prevention (CDC) has

formulated special criteria for CFS [3].

In published studies, fatigue is mostly described as a multicausal,

multidimensional and complex concept in which psychological,

biochemical and physiological mechanisms play a role. As with pain,

the definition is not the most important issue in clinical practice

but the way fatigue can and should be assessed is, because quantifying

fatigue enables us to study fatigue.

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Read the full editorial here:

http://rheumatology.oxfordjournals.org/cgi/content/full/48/3/207?etoc

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