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Abstract
Background
Psoriatic arthritis is associated with psychosocial morbidity and decrease in quality of life. Psychiatric comorbidity also plays an important role in the impairment of quality of life and onset of fatigue.
Objectives
This study aimed to assess the prevalence of fatigue in psoriatic arthritis patients and to correlate it to quality of life indexes, functional capacity, anxiety, depression and disease activity.
Patients and methods
This cross-sectional study was performed on outpatients with psoriatic arthritis. Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F; version 4) was used to measure fatigue; 36-Item Short Form Health Survey (SF-36) and Psoriasis Disability Index (PDI) to measure quality of life; Health Assessment Questionnaire (HAQ) to assess functional capacity; Hospital Anxiety and Depression (HAD) scale to measure anxiety and depression symptoms; Psoriasis Area and Severity Index (PASI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Clinical Disease Activity Index (CDAI) to evaluate clinical activity.
Results
In all, 101 patients with mean age of 50.77 years were included. The mean PDI score was 8.01; PASI score, 9.88; BASDAI score, 3.59; HAQ score, 0.85; HAD – Anxiety (HAD A) score, 7.39; HAD Depression (HAD D) score, 5.93; FACIT–Fatigue Scale (FACIT-FS) score, 38.3 and CDAI score, 2.65. FACIT-FS was statistically associated with PASI (rs −0.345, p<0.001), PDI (rs −0.299, p<0.002), HAQ (rs −0.460, p<0.001), HAD A (rs −0.306, p=0.002) and HAD D (rs −0.339, p<0.001). The correlations with CDAI and BASDAI were not confirmed. There was statistically significant correlation with all of the domains of SF-36 and FACIT-F (version 4).
Conclusion
Prevalence of fatigue was moderate to intense in <25% of patients with psoriatic arthritis. Fatigue seems to be more related to the emotional and social aspects of the disease than to joint inflammatory aspects, confirming that the disease’s visibility is the most disturbing aspect for the patient and that “skin pain” is more intense than the joint pain.
Acknowledgments
This work was supported by CNPq (National Council of Scientific and Technological Development). The authors hereby state that the current paper is based on the Master’s thesis submitted by Dr Claudio Carneiro, who obtained the title of Master of Sciences from the University of the State of Rio de Janeiro with this thesis.
Disclosure
The authors report no conflicts of interest in this work.