Background Fatigue is one of the most complex and ill understood symptoms of chronic illness often reported as the number one complaint by patients with systemic lupus erythematosus (SLE).
Objectives This paper aims to provide a comprehensive review of the literature of fatigue in SLE and more specifically to examine the literature regarding:
a) The measurement, prevalence and nature of fatigue in SLE
b) The role of disease variables and comorbid conditions in relation to fatigue in SLE
c) the association of psychosocial variables with fatigue in SLE
d) the effectiveness of non-pharmacological interventions for fatigue in SLE
Methods Electronic searches were performed on 6 databases including AMED, Cinahl, EMBASE, Medline, PsychINFO and PubMed. Primary reference lists of retrieved articles were scanned for any potentially relevant papers. Studies were selected for review if they were reviewing a formally diagnosed SLE sample and utilised a fatigue-specific measure.
Results Fatigue was assessed by a range of self-report instruments, the content of which varies significantly. The results displayed a consensus on the high prevelance of fatigue in SLE, which is significantly higher when compared to controls. The aetiology of fatigue appears to be multifactorial. Disease activity and other disease related variables (e.g. organ damage & disease duration) are not always significantly associated with fatigue, in comparison with other secondary features of SLE (e.g. sleep difficulties, pain & physical deconditioning) and psychological variables. There is some evidence to suggest the potential of non-pharmacological interventions in reducing fatigue in SLE.
Conclusions The literature is limited by the cross-sectional nature of most of the studies that do not permit for any firm conclusion regarding the direction of causal relationships to be made. The high prevalence of fatigue in SLE emphasises the need for further detailed prospective research to inform the understanding of its aetiology, course, and management.
Disclosure of Interest None Declared