January 18, 2019

An observational study published in Lupus of people with lupus found that of six factors,  stress, depression and pain contributed most to fatigue, one of the most debilitating symptoms of the disease.

The study involved 116 ethnically diverse, primarily female participants (91%) diagnosed with lupus receiving care at university medical centers. Each person  completed several assessments of disease activity and quality of life outcomes using common evaluation tools.  The study goal was to evaluate the effects of six factors —  (disease activity, insomnia, depression, stress, pain and physical health) to fatigue for people with lupus who do not also have fibromyalgia.

Depression, stress and pain were significantly and independently associated with fatigue, but not disease activity, sleep or physical health. Stress had the largest effect on fatigue, followed by depression.

Investigators concluded: “The results emphasize the need to evaluate and treat fatigue in individuals with SLE utilizing a biopsychosocial approach, particularly in the realm of clinical trials. Behavioral medicine interventions are shown to be most effective for the treatment of depression, stress and pain.”