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. 2017 May 8:10:155-163.
doi: 10.2147/CCID.S124886. eCollection 2017.

Evaluation of fatigue and its correlation with quality of life index, anxiety symptoms, depression and activity of disease in patients with psoriatic arthritis

Claudio Carneiro  1   2 , Mario Chaves  2 , Gustavo Verardino  2 , Ana Paula Frade  3 , Pedro Guimaraes Coscarelli  4 , Washington Alves Bianchi  5   6 , Marcia Ramos-E-Silva  3 , Sueli Carneiro  2   3
Affiliations

Evaluation of fatigue and its correlation with quality of life index, anxiety symptoms, depression and activity of disease in patients with psoriatic arthritis

Claudio Carneiro et al. Clin Cosmet Investig Dermatol. .

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.

Keywords: anxiety; arthritis; depression; fatigue; psoriasis; quality of life; questionnaires.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of FACIT-FS scores. Abbreviation: FACIT-FS, Functional Assessment of Chronic Illness Therapy – Fatigue Scale.
Figure 2
Figure 2
Correlation between FACIT-FS scores and (A) PASI, (B) PDI, (C) BASDAI and (D) CDAI scales. Note: Scatter plots and adjustment curves of 95% CI (confidence interval) are shown. Abbreviations: FACIT-FS, Functional Assessment of Chronic Illness Therapy – Fatigue Scale; PASI, Psoriasis Area and Severity Index; PDI, Psoriasis Disability Index; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; CDAI, Clinical Disease Activity Index.
Figure 3
Figure 3
Correlation between FACIT-FS scores and (A) HAQ, (B) HAD A and (C) HAD D scales. Note: Scatter plots and adjustment curves of 95% CI (confidence interval) are shown. Abbreviations: FACIT-FS, Functional Assessment of Chronic Illness Therapy – Fatigue Scale; HAQ, Health Assessment Questionnaire; HAD A/D, Hospital Anxiety and Depression scale – Anxiety/Depression.
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