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Rheumatology Advance Access originally published online on August 13, 2008
Rheumatology 2008 47(10):1559-1563; doi:10.1093/rheumatology/ken331
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A systematic comparison of fatigue levels in systemic sclerosis with general population, cancer and rheumatic disease samples

B. D. Thombs1, M. Bassel1, L. McGuire2, M. T. Smith3, M. Hudson4 and J. A. Haythornthwaite3

1Department of Psychiatry, McGill University and Sir Mortimer B. Davis – Jewish General Hospital, Montreal, Quebec, Canada, 2Department of Psychology, University of Maryland, Baltimore County, 3Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA and 4Division of Rheumatology, McGill University and Sir Mortimer B. Davis – Jewish General Hospital, Montreal, Quebec, Canada.

Correspondence to: B. D. Thombs, Sir Mortimer B. Davis – Jewish General Hospital, Institute of Community and Family Psychiatry, 4333 Cote Ste Catherine Road, Montreal, Quebec H3T 1E4, Canada. E-mail: brett.thombs{at}mcgill.ca


  Abstract

Objectives. There are no studies of fatigue levels in patients with SSc. The objective of this study was to compare fatigue in SSc to general population samples and patients with rheumatic diseases and cancer, where fatigue has been researched extensively.

Methods. SSc patients completed the General Fatigue Index (GFI) of the Multidimensional Fatigue Inventory. A systematic review was conducted to select comparison samples. Mean GFI scores from SSc patients were compared with mean scores from comparison samples with t-tests and Bonferroni corrections (family-wise P < 0.05).

Results. A total of 106 SSc patients were sampled (97 females; 28 diffuse SSc; 11.9 ± 7.9 yrs since diagnosis). Based on comparisons from the systematic review, mean GFI scores in SSc (13.3 ± 4.6) were significantly higher (greater fatigue; P < 0.05) than in two large population samples (8.7 and 9.6) and than in two samples of cancer patients in remission (9.4 and 10.0). Scores for the SSc sample were significantly lower (less fatigue) compared with two samples of cancer patients in palliative care (16.8 and 17.0). SSc GFI scores were similar to scores from patients with RA (13.4), AS (13.0) and SLE (13.1) and to scores from six studies of cancer patients in active treatment (11.1–13.5).

Conclusions. The high levels of fatigue reported in SSc were similar to patients with varying types and treatment stages of cancer and patients with other rheumatic diseases when assessed with the GFI, demonstrating that fatigue warrants greater attention in SSc.

KEY WORDS: Systemic sclerosis, Fatigue, Systematic review, Multidimensional Fatigue Inventory

Submitted 18 April 2008; revised version accepted 11 July 2008.
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