15
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

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

      research-article
      1 , 2 , 3 , 3 , 3 , 3 , 4 , 1 , 5 , 6 , 7 , 8 , 9 , 10 , 10 , 11 , 12 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 3 , 30 , 30 , 31 ,
      RMD Open
      BMJ Publishing Group
      Sjogren’s syndrome, fatigue, comorbidities, concomitant medications, pain, depression

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives

          To 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.

          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 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 comorbidities 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 patients with pSS.

          This finding is robust to both the effect of other comorbidities associated with fatigue and medications associated with drowsiness.

          Related collections

          Most cited references37

          • Record: found
          • Abstract: found
          • Article: not found

          Distinguishing sleepiness and fatigue: focus on definition and measurement.

          Sleepiness and fatigue are two interrelated, but distinct phenomena; observed in a number of psychiatric, medical and primary sleep disorders. Despite their different implications in terms of diagnosis and treatment, these two terms are often used interchangeably, or merged under the more general lay term of 'tired'. Sleepiness is multidimensional and has many causes (multidetermined) and distinguished from fatigue by a presumed impairment of the normal arousal mechanism. Despite its ubiquity, no clear consensus exits as yet as to what constitutes sleepiness. Definitions of sleepiness, to date, are at best operational definitions, conceptualized so as to produce specific assessment instruments. As a result, while a number of subjective and objective measurement tools have been developed to measure sleepiness, each only captures a limited aspect of an otherwise heterogeneous entity. Fatigue is an equally complex phenomenon, its nature captured by a number of conceptualizations and definitions. Measures of fatigue have remained subjective, with a 'gold standard' for its measurement remaining elusive. Despite a high prevalence and high degree of morbidity, fatigue has remained a relatively under appreciated symptom, from both a clinical and research point of view.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Validation of EULAR primary Sjögren's syndrome disease activity (ESSDAI) and patient indexes (ESSPRI).

            To validate the two recently developed disease activity indexes for assessment of primary Sjögren's syndrome (SS): the European League Against Rheumatism (EULAR) SS Patient Reported Index (ESSPRI) and the EULAR SS Disease Activity Index (ESSDAI).
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders.

              Insomnia is a pervasive problem for many patients suffering from medical and psychiatric conditions. Even when the comorbid disorders are successfully treated, insomnia often fails to remit. In addition to compromising quality of life, untreated insomnia may also aggravate and complicate recovery from the comorbid disease. Cognitive behavior therapy for insomnia (CBT-I) has an established efficacy for primary insomnia, but less is known about its efficacy for insomnia occurring in the context of medical and psychiatric conditions. The purpose of this article is to present a rationale for using CBT-I in medical and psychiatric disorders, review the extant outcome literature, highlight considerations for adapting CBT-I procedures in specific populations, and suggest directions for future research. Outcome studies were identified for CBT-I in mixed medical and psychiatric conditions, cancer, chronic pain, HIV, depression, posttraumatic stress disorder, and alcoholism. Other disorders discussed include: bipolar disorder, eating disorders, generalized anxiety, and obsessive compulsive disorder. The available data demonstrate moderate to large treatment effects (Cohen's d, range=0.35-2.2) and indicate that CBT-I is a promising treatment for individuals with medical and psychiatric comorbidity. Although the literature reviewed here is limited by a paucity of randomized, controlled studies, the available data suggest that by improving sleep, CBT-I might also indirectly improve medical and psychological endpoints. This review underscores the need for future research to test the efficacy of adaptations of CBT-I to disease specific conditions and symptoms.
                Bookmark

                Author and article information

                Journal
                RMD Open
                RMD Open
                rmdopen
                rmdopen
                RMD Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2056-5933
                2019
                24 April 2019
                : 5
                : 1
                : e000885
                Affiliations
                [1 ]departmentDepartment of Life & Health Sciences , Northumbria University Department of Public Health and Wellbeing , Newcastle upon Tyne, UK
                [2 ]departmentMusculoskeletal Research Group , Newcastle University Faculty of Medical Sciences , Newcastle upon Tyne, UK
                [3 ]departmentMusculoskeletal Research Group , Newcastle University Faculty of Medical Sciences , Newcastle upon Tyne, UK
                [4 ]departmentDepartamento de Educação Integrada em Saúde , Universidade Federal do Espirito Santo , Vitoria, Brazil
                [5 ]departmentMusculoskeletal Services , Newcastle Upon Tyne Hospitals NHS Foundation Trust , Newcastle Upon Tyne, UK
                [6 ]departmentRheumatology Research Group , University of Birmingham , Birmingham, UK
                [7 ]departmentRheumatology , Great Western Hospitals NHS Foundation Trust , Swindon, UK
                [8 ]departmentRheumatology , Leeds Teaching Hospitals NHS Trust , Leeds, UK
                [9 ]departmentRheumatology , University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine , Leeds, UK
                [10 ]departmentMusculoskeletal , NIHR Leeds Musculoskeletal Biomedical Research Unit , Leeds, UK
                [11 ]departmentRheumatology , Nottingham University Hospitals NHS Trust , Nottingham, UK
                [12 ]Gartnavel General Hospital , Glasgow, UK
                [13 ]departmentExperimental Medicine and Rheumatology , Queen Mary University of London , London, UK
                [14 ]Barts Health NHS Trust , London, UK
                [15 ]departmentRheumatology , Barts and The London School of Medicine and Dentistry , London, UK
                [16 ]departmentExperimental Medicine and Rheumatology , William Harvey Research Institute Experimental Medicine and Musculoskeletal Sciences , London, UK
                [17 ]NHS Fife , Kirkcaldy, UK
                [18 ]Royal Hampshire County Hospital , Winchester, UK
                [19 ]Royal Derby Hospital , Derby, UK
                [20 ]departmentCentre for Rheumatology , University College London , London, UK
                [21 ]Queen Elizabeth Hospital , Gateshead, UK
                [22 ]City Hospitals Sunderland NHS Foundation Trust , Sunderland, UK
                [23 ]departmentDepartment of Rheumatology , Southend University Hospital NHS Foundation Trust , Westcliff-on-Sea, UK
                [24 ]departmentDepartment of Pharmacy and Pharmacology , University of Bath , Bath, UK
                [25 ]departmentRheumatology , Portsmouth Hospitals NHS Trust , Portsmouth, UK
                [26 ]departmentRheumatology , Aintree University Hospitals , Liverpool, UK
                [27 ]departmentDepartment of Rheumatology , Basildon Hospital , Basildon, UK
                [28 ]departmentDepartment of Rheumatology , Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield, UK
                [29 ]departmentMusculoskeletal Services , Newcastle Upon Tyne Hospitals NHS Foundation Trust , Newcastle Upon Tyne, UK
                [30 ]departmentMusculoskeletal Ageing , NIHR Newcastle Biomedical Research Centre , Newcastle upon Tyne, UK
                [31 ]departmentMusculoskeletal Research Group , Newcastle University Faculty of Medical Sciences , Newcastle upon Tyne, UK
                Author notes
                [Correspondence to ] Dr Wan-Fai Ng; wan-fai.ng@ 123456newcastle.ac.uk

                KLH and KD are joint first authors.

                Author information
                https://orcid.org/0000-0002-9855-6802
                http://orcid.org/0000-0001-7019-6211
                http://orcid.org/0000-0001-6268-5509
                Article
                rmdopen-2018-000885
                10.1136/rmdopen-2018-000885
                6525628
                31168409
                585dbc75-979e-4f84-a3b3-99f498c90ccb
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 18 December 2018
                : 20 March 2019
                : 27 March 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: G0800629
                Categories
                Sjögren Syndrome
                1506
                Original article
                Custom metadata
                unlocked

                sjogren’s syndrome,fatigue,comorbidities,concomitant medications,pain,depression

                Comments

                Comment on this article