Ann Rheum Dis 1998;57:291-295 ( May )

Extended reports

Fatigue in primary Sjögren's syndrome P J Barendregt,^a M R M Visser,^b E M A Smets,^b J H M Tulen,^c A H van den Meiracker,^d F Boomsma,^d H M Markusse^a

^a Department of Rheumatology, Zuiderziekenhuis, Rotterdam, the Netherlands, ^b Department of Medical Psychology, Academic Medical Centre, Amsterdam, the Netherlands, ^c Departments of Psychiatry, ^d and Internal Medicine I, ^e University Hospital Rotterdam-Dijkzigt, Rotterdam, the Netherlands

Correspondence to: P J Barendregt, Department of Rheumatology, Zuiderziekenhuis, Groene Hilledijk 315, 3075 EA Rotterdam, the Netherlands.

Accepted for publication 10 March 1998

OBJECTIVETo assess fatigue in relation to depression, blood pressure, and plasma catecholamines in patients with primary Sjögren's syndrome (SS), in comparison with healthy controls and patients with rheumatoid arthritis.
METHODSFor the assessment of fatigue the Multidimensional Fatigue Inventory (MFI) was used, a 20 item questionnaire, covering the following dimensions: general fatigue, physical fatigue, mental fatigue, reduced motivation, and reduced activity. Furthermore, the Zung depression scale was used to quantify aspects of depression. Forty nine female primary SS patients, 44 female patients with rheumatoid arthritis (RA), and 32 healthy women filled in both questionnaires. In addition, supine values of blood pressure and plasma catecholamines were measured in the patients with primary SS.
RESULTSPrimary SS patients were more fatigued compared with the healthy controls on all the five dimensions of the MFI. When the analyses were repeated using depression as a covariate, group differences disappeared for the dimensions of reduced motivation and mental fatigue. In the primary SS patients, significant positive correlations between depression and the dimensions of reduced motivation and mental fatigue were found. Comparing patients with primary SS with those with RA, using depression as covariate, no statistically significant differences were found between these groups. No relation between fatigue and blood pressure was found, but a negative correlation was observed between the general fatigue subscale of the MFI and plasma noradrenaline.
CONCLUSIONPatients with primary SS report more fatigue than healthy controls on all the dimensions of the MFI and when controlling for depression significant differences remain on the dimensions of general fatigue, physical fatigue, and reduced activity. The negative correlations between levels of noradrenaline and general fatigue in patients with primary SS may imply the involvement of the autonomic nervous system in chronic fatigue.

Keywords: Sjögren's syndrome; fatigue

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© 1998 by Annals of the Rheumatic Diseases
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