Perry M Nicassio1, Sarah R Ormseth, Mara K Custodio, Michael R Irwin, Richard Olmstead, Michael H Weisman. 1. Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 300 UCLA Medical Plaza, Los Angeles, CA 90095-7076, USA. pnicassio@mednet.ucla.edu
Abstract
OBJECTIVE: To evaluate a multidimensional model testing disease activity, mood disturbance, and poor sleep quality as determinants of fatigue in patients with rheumatoid arthritis (RA). METHOD: The data of 106 participants were drawn from baseline of a randomized comparative efficacy trial of psychosocial interventions for RA. Sets of reliable and valid measures were used to represent model constructs. Structural equation modeling was used to test the direct effects of disease activity, mood disturbance, and poor sleep quality on fatigue, as well as the indirect effects of disease activity as mediated by mood disturbance and poor sleep quality. RESULTS: The final model fit the data well, and the specified predictors explained 62% of the variance in fatigue. Higher levels of disease activity, mood disturbance, and poor sleep quality had direct effects on fatigue. Disease activity was indirectly related to fatigue through its effects on mood disturbance, which in turn was related to poor sleep quality. Mood disturbance also indirectly influenced fatigue through poor sleep quality. CONCLUSION: Our findings confirmed the importance of a multidimensional framework in evaluating the contribution of disease activity, mood disturbance, and sleep quality to fatigue in RA using a structural equation approach. Mood disturbance and poor sleep quality played major roles in explaining fatigue along with patient-reported disease activity.
RCT Entities:
OBJECTIVE: To evaluate a multidimensional model testing disease activity, mood disturbance, and poor sleep quality as determinants of fatigue in patients with rheumatoid arthritis (RA). METHOD: The data of 106 participants were drawn from baseline of a randomized comparative efficacy trial of psychosocial interventions for RA. Sets of reliable and valid measures were used to represent model constructs. Structural equation modeling was used to test the direct effects of disease activity, mood disturbance, and poor sleep quality on fatigue, as well as the indirect effects of disease activity as mediated by mood disturbance and poor sleep quality. RESULTS: The final model fit the data well, and the specified predictors explained 62% of the variance in fatigue. Higher levels of disease activity, mood disturbance, and poor sleep quality had direct effects on fatigue. Disease activity was indirectly related to fatigue through its effects on mood disturbance, which in turn was related to poor sleep quality. Mood disturbance also indirectly influenced fatigue through poor sleep quality. CONCLUSION: Our findings confirmed the importance of a multidimensional framework in evaluating the contribution of disease activity, mood disturbance, and sleep quality to fatigue in RA using a structural equation approach. Mood disturbance and poor sleep quality played major roles in explaining fatigue along with patient-reported disease activity.
Authors: Julio Fernandez-Mendoza; Susan L Calhoun; Edward O Bixler; Maria Karataraki; Duanping Liao; Antonio Vela-Bueno; María Jose Ramos-Platon; Katherine A Sauder; Maria Basta; Alexandros N Vgontzas Journal: Psychosom Med Date: 2010-10-26 Impact factor: 4.312
Authors: Faith S Luyster; Eileen R Chasens; Mary Chester M Wasko; Jacqueline Dunbar-Jacob Journal: J Clin Sleep Med Date: 2011-02-15 Impact factor: 4.062
Authors: George A Wells; Tracy Li; John R Kirwan; Joan Peterson; Daniel Aletaha; Maarten Boers; Barry Bresnihan; Maxime Dougados; Leanne Idzerda; Jo Nicklin; Maria Suarez-Almazor; Vivian Welch; Peter S Tugwell Journal: J Rheumatol Date: 2009-09 Impact factor: 4.666
Authors: Martin J Bergman; Shadi H Shahouri; Shadi S Shahouri; Timothy S Shaver; James D Anderson; David N Weidensaul; Ruth E Busch; Shirley Wang; Frederick Wolfe Journal: J Rheumatol Date: 2009-11-16 Impact factor: 4.666
Authors: Patricia Katz; Mary Margaretten; Laura Trupin; Gabriela Schmajuk; Jinoos Yazdany; Edward Yelin Journal: Arthritis Care Res (Hoboken) Date: 2016-01 Impact factor: 4.794
Authors: Nada Lukkahatai; Brian Walitt; Alexandra Espina; Alves Gelio; Leorey N Saligan Journal: Arthritis Care Res (Hoboken) Date: 2016-01 Impact factor: 4.794
Authors: Jungeun Lee; Huong Q Nguyen; Monica E Jarrett; Pamela H Mitchell; Kenneth C Pike; Vincent S Fan Journal: Heart Lung Date: 2018-02-01 Impact factor: 2.210
Authors: Elizabeth D Bacci; Amy M DeLozier; Chen-Yen Lin; Carol L Gaich; Xiang Zhang; Terence Rooney; Stephanie de Bono; Richard Hoffman; Kathleen W Wyrwich Journal: Health Qual Life Outcomes Date: 2017-12-06 Impact factor: 3.186
Authors: S Hewlett; N Ambler; C Almeida; P S Blair; E Choy; E Dures; A Hammond; W Hollingworth; J Kirwan; Z Plummer; C Rooke; J Thorn; K Tomkinson; J Pollock Journal: BMJ Open Date: 2015-08-06 Impact factor: 2.692