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. 2022 Dec 23;62(1):190-199.
doi: 10.1093/rheumatology/keac207.

Fibromyalgia, mood disorders, cognitive test results, cognitive symptoms and quality of life in systemic lupus erythematosus

Sudha Raghunath  1   2 , Emma K Guymer  1   2 , Yifat Glikmann-Johnston  3 , Vera Golder  1   2 , Rangi Kandane Rathnayake  1 , Eric F Morand  1   2 , Julie C Stout  3 , Alberta Hoi  1   2
Affiliations

Fibromyalgia, mood disorders, cognitive test results, cognitive symptoms and quality of life in systemic lupus erythematosus

Sudha Raghunath et al. Rheumatology (Oxford). .

Abstract

Objectives: Cognitive dysfunction, and comorbidities such as mood disorder and fibromyalgia, are common in SLE. This study aims to explore the associations between fibromyalgia, mood disorders, cognitive symptoms and cognitive dysfunction in SLE patients, and their impact on quality of life.

Methods: We tested cognition in SLE patients and healthy controls, and evaluated cognitive symptoms, mood disorder, fibromyalgia, fatigue and quality of life using patient-reported outcome measures. We examined associations of these comorbidities with both patient-reported cognitive symptoms and cognitive test performance.

Results: High fibromyalgia symptom score and history of depression or anxiety were associated with cognitive dysfunction. There were no significant associations between current depression, anxiety symptoms or fatigue score and objective cognitive dysfunction. In contrast, mood disorder symptoms, history of mood disorder, fibromyalgia symptoms and fatigue all had significant associations with patient-reported cognitive symptoms. There were no significant associations between patient-reported cognitive symptoms and objective cognitive dysfunction. Objective cognitive dysfunction, patient-reported cognitive symptoms, history of mood disorder and fibromyalgia symptoms all had significant associations with poorer quality of life; fibromyalgia had the biggest impact.

Conclusions: Cognitive symptoms are common in SLE, but there were no associations between cognitive symptoms and objective cognitive dysfunction. Depression, anxiety and fibromyalgia were more consistently associated with patient-reported cognitive symptoms than with objective cognitive dysfunction. These factors all have a significant impact on quality of life. Understanding the discrepancy between patient-reported cognitive symptoms and cognitive test performance is essential to advance care in this area of unmet need.

Keywords: SLE; cognitive dysfunction; depression; fibromyalgia; quality of life.

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Figures

<sc>Fig</sc>. 1
Fig. 1
Impact of cognitive dysfunction, symptoms, mood disorders and fibromyalgia on quality of life in SLE Line charts comparing median scores in each of the eight short form 36 (SF-36) domains between SLE patients with impaired and preserved cognition on testing using the pooled definition (A), high vs low cognitive symptom scores on the Cognitive Symptoms Inventory (B), past history of anxiety or depression vs no history of mood disorders (C), and fibromyalgia vs no fibromyalgia (D). *P < 0.05, **P < 0.005, #P < 0.0005. SF-36 domains: PF: physical functioning, RP: role physical, BP: bodily pain, GH: general health, VT: vitality, SF: social functioning, RE: role emotional, MH: mental health. Sx: symptoms.
See this image and copyright information in PMC

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