Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren’s syndrome

• Published in: Rheumatic & musculoskeletal diseases open Vol. 5; no. 1; p. e000885
• Main Authors: Hackett, Kate L, Davies, Kristen, Tarn, Jessica, Bragg, Rebecca, Hargreaves, Ben, Miyamoto, Samira, McMeekin, Peter, Mitchell, Sheryl, Bowman, Simon, Price, Elizabeth J, Pease, Colin, Emery, Paul, Andrews, Jacqueline, Lanyon, Peter, Hunter, John, Gupta, Monica, Bombardieri, Michele, Sutcliffe, Nurhan, Pitzalis, Costantino, McLaren, John, Cooper, Annie, Regan, Marian, Giles, Ian, Isenberg, David, Vadivelu, Saravan, Coady, David, Dasgupta, Bhaskar, McHugh, Neil, Young-Min, Steven, Moots, Robert, Gendi, Nagui, Akil, Mohammed, Griffiths, Bridget, Lendrem, Dennis W, Ng, Wan-Fai
• Format: Journal Article
• Language: English
• Published: England EULAR 01.04.2019; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original article
• Subjects: Adolescent; Anemia; Antidepressants; Anxiety; Behavior modification; Body mass index; Celiac disease; Child; Child, Preschool; Cognition & reasoning; comorbidities; Comorbidity; concomitant medications; depression; Depression - drug therapy; Depression - epidemiology; Depression - etiology; Diabetes; Fatigue; Female; Fibromyalgia; Humans; Hypothyroidism; Insomnia; Mental Fatigue - drug therapy; Mental Fatigue - epidemiology; Mental Fatigue - etiology; Obesity; Pain; Pain - drug therapy; Pain - epidemiology; Pain - etiology; Patients; Physical Examination; Psychotropic drugs; Registries; Regression analysis; Research ethics; Rheumatoid arthritis; Rheumatology; Severity of Illness Index; Sjogren's Syndrome - drug therapy; Sjogren's Syndrome - epidemiology; Sjogren's Syndrome - psychology; Sjogren’s syndrome; Sjögren Syndrome; Sleep apnea; Sleep disorders; Studies; Systematic review; Thyroid gland; United Kingdom - epidemiology; United Kingdom; United Kingdom > UK; fatigue; pain; Sjogren’s syndrome; concomitant medications; depression; comorbidities
• ISSN: 2056-5933; 2056-5933
• DOI: 10.1136/rmdopen-2018-000885

ObjectivesTo report on fatigue in patients from the United Kingdom primary Sjögren’s syndrome (pSS) registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.MethodsFrom our cohort (n = 608), we identified those with comorbidities associated with fatigue, and those taking medications associated with drowsiness. We constructed dummy variables, permitting the contribution of these potentially assignable causes of fatigue to be assessed. Using multiple regression analysis, we modelled the relationship between Profile of Fatigue and Discomfort physical and mental fatigue scores and potentially related variables.ResultsPain, depression and daytime sleepiness scores were closely associated with both physical and mental fatigue (all p ≤ 0.0001). In addition, dryness was strongly associated with physical fatigue (p ≤ 0.0001). These effects were observed even after adjustment for comorbidities associated with fatigue or medications associated with drowsiness.ConclusionsThese findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in patients with pSS.This finding is robust to both the effect of other comorbidities associated with fatigue and medications associated with drowsiness.