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Depression, fatigue, and pain in systemic lupus erythematosus (SLE): Relationship to the American College of Rheumatology SLE neuropsychological battery

  1. Elizabeth Kozora1,*,
  2. Misoo C. Ellison2,
  3. Sterling West3

Article first published online: 27 JUL 2006

DOI: 10.1002/art.22101

Issue

Arthritis Care & Research

Arthritis Care & Research

Volume 55, Issue 4, pages 628–635, 15 August 2006

Additional Information

How to Cite

Kozora, E., Ellison, M. C. and West, S. (2006), Depression, fatigue, and pain in systemic lupus erythematosus (SLE): Relationship to the American College of Rheumatology SLE neuropsychological battery. Arthritis Care & Research, 55: 628–635. doi: 10.1002/art.22101

Author Information

  1. 1

    National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver

  2. 2

    Office of Academic Affairs, National Jewish Medical and Research Center, Denver, Colorado

  3. 3

    University of Colorado Health Sciences Center, Denver

*National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206

Publication History

  1. Issue published online: 27 JUL 2006
  2. Article first published online: 27 JUL 2006
  3. Manuscript Accepted: 10 NOV 2005
  4. Manuscript Received: 13 MAY 2005

Funded by

  • Rocky Mountain Arthritis Chapter
  • The Lupus Foundation of Colorado (Denver)
  • National Institute of Mental Health. Grant Number: RO3-MH-63744-011

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Keywords:

  • Systemic lupus erythematosus;
  • Neuropsychology;
  • Depression;
  • Pain;
  • Fatigue

Abstract

Objective

To examine the frequency and reliability of depression, fatigue, and pain self-report measures in patients with systemic lupus erythematosus (SLE) and healthy controls, and to examine the relationship between a cognitive impairment index (CII) derived from the American College of Rheumatology neuropsychology research battery of tests for SLE (ACR-SLE battery) and measures of depression, pain, fatigue, and perceived cognitive dysfunction.

Methods

Thirty-one patients with SLE with a history of overt neuropsychiatric symptoms (neuropsychiatric SLE [NPSLE]), 22 patients with SLE without overt neuropsychiatric symptoms (non-NPSLE), and 25 healthy controls completed the following measures at baseline and 1-month followup: ACR-SLE battery, perceived cognitive difficulties, depression, fatigue, and pain.

Results

Patients with SLE (both NPSLE and non-NPSLE) showed higher symptoms of depression, higher levels of fatigue, greater pain, and more perceived cognitive problems. All measures except the Center for Epidemiologic Studies Depression scale (CES-D) demonstrated adequate reliability across the SLE groups at retest. Only patients with NPSLE had significant correlations between CII and depression, fatigue, and pain. Neither the non-NPSLE patients nor the controls had significant relationships with the CII and these behavioral measures.

Conclusion

Patients with SLE report higher levels of cognitive difficulties, depression, pain, and fatigue compared with controls. Reliability for all measures, except the CES-D, was established in the SLE group. Overall, results suggest that cognitive dysfunction, pain, fatigue, and depression in patients with NPSLE may represent global changes in the central nervous system that require ongoing evaluation and treatment.

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