Background Fatigue is a common problem in patients with rheumatic disease. It may cause disability and poor quality of life (1). Although fatigue and its determinants are studied in several rheumatic diseases, there is no study in Familial Mediterranean Fever (FMF).
Objectives The aim of this study is to investigate fatigue in FMF patients as a disabiling symptom and its associations with clinical and demographic variables.
Methods FMF patients were recruited into the study according to FMF Tel Hashomer criteria (2). Control group composed of healthy individuals. Patients who were pregnant or who had concomitant medical illnesses such as cancer, fibromyalgia, or psychiatric conditions such as psychosis or bipolar disorder were excluded. Age, gender, disease duration, education, marital status were noted as demographic features. Number of attacks in the last year, type of attack, involvement of joints, dosage of colchicine, genotype, amyloidosis, and severity of FMF was assessed with PRAS score, visual analogue score of pain (VAS-pain) and VAS-fatigue were used as clinical parameters. Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF), Nottingham Health Profile (NHP), Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS) and Hospital Anxiety and Depression Scale (HADS) were filled out by both control and study group. Assessment of normality was analyzed with Shapiro-Wilk test. Differences in the mean scores of control and study group were compared with independent samples Mann-Whitney U and Kruskal-Wallis test. Relationship between continuous variables was assessed with Spearman's correlation coefficient (rho).
Results 61 FMF patients and 61 age, gender (44 female, 17 male in each group) matched controls were enrolled into the study. Mean age of FMF and control group were 35.5±11.8 and 35.8±11.7 years, respectively. The mean disease duration was 82.5±81.7 months. Difference between mean of VAS-pain, VAS-fatigue, PSQI total score, MAF, all subsets of NHP, FSS, FIS, HADS scores of FMF patients were significantly higher than control group (p<0.0001). The correlations between scales assessing fatigue and other outcome measures in FMF patients was shown in Table.
Conclusions This study has shown that fatigue in FMF is associated with a number of psychological, sleep, quality of life and disease related factors. FMF group had increased pain, fatigue, sleep disturbance and decreased quality of life compared to control group. FMF patients with fatigue may benefit from pharmacological and psychological interventions which target these factors.
Nikolaus, Stephanie, et al. Fatigue and factors related to fatigue in rheumatoid arthritis: a systematic review. Arthritis care & research 65.7 (2013): 1128–1146.
Livneh, Avi, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis & Rheumatology 40.10 (1997): 1879–1885.
Disclosure of Interest None declared
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