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

Katie Hackett; Kristen Davies; Jessica Tarn; Rebecca Bragg; Ben Hargreaves; Samira Miyamoto; Sheryl Mitchell; Peter McMeekin; Simon Bowman; Elizabeth Price; Colin Pease; Paul Emery; Peter Lanyon; John Hunter; Monica Gupta; Michele Bombardieri; Nurhan Sutcliffe; Constantino Pitzalis; John McLaren; Annie Cooper; Marian Regan; Ian Giles; David Isenberg; Saravanan Vadivelu; David Coady; Bhaskar Dasgupta; Neil McHugh; Steven Young-Min; Robert Moots; Nagui Gendi; Mohammed Akil; Bridget Griffiths; Dennis Lendrem; Wan-Fai Ng

doi:10.1136/rmdopen-2018-000885

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

Katie Hackett, Kristen Davies, Jessica Tarn, Rebecca Bragg, Ben Hargreaves, Samira Miyamoto, Sheryl Mitchell, Peter McMeekin, Simon Bowman, Elizabeth Price, Colin Pease, Paul Emery, Peter Lanyon, John Hunter, Monica Gupta, Michele Bombardieri, Nurhan Sutcliffe, Constantino Pitzalis, John McLaren, Annie CooperMarian Regan, Ian Giles, David Isenberg, Saravanan Vadivelu, David Coady, Bhaskar Dasgupta, Neil McHugh, Steven Young-Min, Robert Moots, Nagui Gendi, Mohammed Akil, Bridget Griffiths, Dennis Lendrem, Wan-Fai Ng

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Abstract

Objectives: To report on fatigue in patients from the United Kingdom Primary Sjögren’s Syndrome Registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.

Methods: From 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 (PROFAD) physical and mental fatigue scores and potentially related variables.

Results: Pain, 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 co-morbidities associated with fatigue or medications associated with drowsiness.

Conclusions: These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in PSS patients.

Original language	English
Article number	e000885
Journal	RMD Open
Volume	5
DOIs	https://doi.org/10.1136/rmdopen-2018-000885
Publication status	Published - 24 Apr 2019

Keywords

Sjogren’s syndrome
fatigue
comorbidities
concomitant medications
pain
depression

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Hackett, K., Davies, K., Tarn, J., Bragg, R., Hargreaves, B., Miyamoto, S., Mitchell, S., McMeekin, P., Bowman, S., Price, E., Pease, C., Emery, P., Lanyon, P., Hunter, J., Gupta, M., Bombardieri, M., Sutcliffe, N., Pitzalis, C., McLaren, J., ... Ng, W.-F. (2019). Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren's syndrome. RMD Open, 5, Article e000885. https://doi.org/10.1136/rmdopen-2018-000885

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title = "Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sj{\"o}gren's syndrome",

abstract = "Objectives: To report on fatigue in patients from the United Kingdom Primary Sj{\"o}gren{\textquoteright}s Syndrome Registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.Methods: From 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 (PROFAD) physical and mental fatigue scores and potentially related variables.Results: Pain, 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 co-morbidities associated with fatigue or medications associated with drowsiness.Conclusions: These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in PSS patients.",

keywords = "Sjogren{\textquoteright}s syndrome, fatigue, comorbidities, concomitant medications, pain, depression",

author = "Katie Hackett and Kristen Davies and Jessica Tarn and Rebecca Bragg and Ben Hargreaves and Samira Miyamoto and Sheryl Mitchell and Peter McMeekin and Simon Bowman and Elizabeth Price and Colin Pease and Paul Emery and Peter Lanyon and John Hunter and Monica Gupta and Michele Bombardieri and Nurhan Sutcliffe and Constantino Pitzalis and John McLaren and Annie Cooper and Marian Regan and Ian Giles and David Isenberg and Saravanan Vadivelu and David Coady and Bhaskar Dasgupta and Neil McHugh and Steven Young-Min and Robert Moots and Nagui Gendi and Mohammed Akil and Bridget Griffiths and Dennis Lendrem and Wan-Fai Ng",

year = "2019",

month = apr,

day = "24",

doi = "10.1136/rmdopen-2018-000885",

language = "English",

volume = "5",

journal = "RMD Open",

issn = "2056-5933",

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Hackett, K, Davies, K, Tarn, J, Bragg, R, Hargreaves, B, Miyamoto, S, Mitchell, S, McMeekin, P, Bowman, S, Price, E, Pease, C, Emery, P, Lanyon, P, Hunter, J, Gupta, M, Bombardieri, M, Sutcliffe, N, Pitzalis, C, McLaren, J, Cooper, A, Regan, M, Giles, I, Isenberg, D, Vadivelu, S, Coady, D, Dasgupta, B, McHugh, N, Young-Min, S, Moots, R, Gendi, N, Akil, M, Griffiths, B, Lendrem, D & Ng, W-F 2019, 'Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren's syndrome', RMD Open, vol. 5, e000885. https://doi.org/10.1136/rmdopen-2018-000885

TY - JOUR

T1 - Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren's syndrome

AU - Hackett, Katie

AU - Davies, Kristen

AU - Tarn, Jessica

AU - Bragg, Rebecca

AU - Hargreaves, Ben

AU - Miyamoto, Samira

AU - Mitchell, Sheryl

AU - McMeekin, Peter

AU - Bowman, Simon

AU - Price, Elizabeth

AU - Pease, Colin

AU - Emery, Paul

AU - Lanyon, Peter

AU - Hunter, John

AU - Gupta, Monica

AU - Bombardieri, Michele

AU - Sutcliffe, Nurhan

AU - Pitzalis, Constantino

AU - McLaren, John

AU - Cooper, Annie

AU - Regan, Marian

AU - Giles, Ian

AU - Isenberg, David

AU - Vadivelu, Saravanan

AU - Coady, David

AU - Dasgupta, Bhaskar

AU - McHugh, Neil

AU - Young-Min, Steven

AU - Moots, Robert

AU - Gendi, Nagui

AU - Akil, Mohammed

AU - Griffiths, Bridget

AU - Lendrem, Dennis

AU - Ng, Wan-Fai

PY - 2019/4/24

Y1 - 2019/4/24

N2 - Objectives: To report on fatigue in patients from the United Kingdom Primary Sjögren’s Syndrome Registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.Methods: From 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 (PROFAD) physical and mental fatigue scores and potentially related variables.Results: Pain, 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 co-morbidities associated with fatigue or medications associated with drowsiness.Conclusions: These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in PSS patients.

AB - Objectives: To report on fatigue in patients from the United Kingdom Primary Sjögren’s Syndrome Registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.Methods: From 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 (PROFAD) physical and mental fatigue scores and potentially related variables.Results: Pain, 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 co-morbidities associated with fatigue or medications associated with drowsiness.Conclusions: These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in PSS patients.

KW - Sjogren’s syndrome

KW - fatigue

KW - comorbidities

KW - concomitant medications

KW - pain

KW - depression

U2 - 10.1136/rmdopen-2018-000885

DO - 10.1136/rmdopen-2018-000885

M3 - Article

SN - 2056-5933

VL - 5

JO - RMD Open

JF - RMD Open

M1 - e000885

ER -

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

Abstract

Keywords

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