Disease status predicts fatigue in systemic lupus erythematosus

Objective. To investigate the relative contributions of disease status, hel plessness. and depression to fatigue in patients with systemic lupus erythe matosus (SLE) in a path-analytic framework. Methods. The disease status of 81 patients with SLE was evaluated by a clin ical rheumatologist using the Systemic Lupus Activity Measure. Patients com pleted self-report measures of psychosocial data, depression, helplessness, and fatigue at 2 assessment periods, 3 months apart, SLE diagnoses were co nfirmed with patients' physicians. Results. The model proposed that SLE disease status would predict fatigue d irectly, and indirectly, through helplessness and depression. At Time 1, di sease status, helplessness, and depression were significantly correlated wi th each other and with fatigue, with helplessness and depression partially mediating the relationship between disease status and fatigue. Longitudinal analyses showed that disease status at Time 1 predicted fatigue, regardles s of helplessness and depression operating as mediators at either Time 1 or Time 2. Conclusion. The cross sectional findings revealed direct and indirect relat ionships between disease status and fatigue, with helplessness and depressi on as mediating variables. However, disease status was the only predictor o f fatigue over time. Disease status also predicted Time 2 helplessness, whi ch, in turn, was associated with Time 2 depression. Fatigue amelioration ma y be an important result of successful management of the underlying SLE pro cess.