{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:26:42Z","timestamp":1791163602995,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2008,11,26]],"date-time":"2008-11-26T00:00:00Z","timestamp":1227657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2008,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the relationship of fatigue severity to other clinical features in primary Sj\u00f6gren's syndrome (SS) and to identify factors contributing to the physical and mental aspects of fatigue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 94 subjects who met the American\u2010European Consensus Group criteria for the classification of primary SS. Fatigue was assessed with a visual analog scale, the Fatigue Severity Scale (FSS), and the Profile of Fatigue (ProF). Associations with fatigue were compared using multivariate regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abnormal fatigue, defined as an FSS score \u22654, was present in 67% of the subjects. Pain, helplessness, and depression were the strongest predictors of fatigue according to the FSS and the somatic fatigue domain of the ProF (ProF\u2010S), both with and without adjustment for physiologic and serologic characteristics. Depression was associated with higher levels of fatigue; however, the majority of subjects with abnormal fatigue were not depressed. Anti\u2010Ro\/SSA\u2013positive subjects were no more likely to report fatigue than seronegative subjects. The regression models explained 62% of the variance in FSS and 78% of the variance in ProF\u2010S scores. Mental fatigue was correlated with depression and helplessness, but the model predicted only 54% of the variance in mental fatigue scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Psychosocial variables are determinants of fatigue, but only partially account for it. Although fatigue is associated with depression, depression is not the primary cause of fatigue in primary SS. Investigation of the pathophysiologic correlates of physical and mental aspects of fatigue is needed to guide the development of more effective interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.24311","type":"journal-article","created":{"date-parts":[[2008,11,26]],"date-time":"2008-11-26T18:34:45Z","timestamp":1227724485000},"page":"1780-1787","source":"Crossref","is-referenced-by-count":140,"title":["Prevalence, severity, and predictors of fatigue in subjects with primary Sj\u00f6gren's syndrome"],"prefix":"10.1002","volume":"59","author":[{"given":"Barbara","family":"Segal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyson","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanlise M.","family":"Leon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketan","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Novitzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rohrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajaram","family":"Gopalakrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu","family":"Nazmul\u2010hossain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshrat","family":"Emamian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Rhodus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,11,26]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kei107"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.23177"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/88.1.26"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-89-6-888"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.57.5.291"},{"key":"e_1_2_7_7_2","first-page":"125","article-title":"Primary Sj\u00f6gren's syndrome: clinical spectrum and mode of presentation based on an analysis of 50 patients selected from a department of rheumatology","volume":"40","author":"Markusse HM","year":"1992","journal-title":"Neth J Med"},{"key":"e_1_2_7_8_2","first-page":"639","article-title":"Comparison of self\u2010reported fatigue in rheumatoid arthritis and controls","volume":"22","author":"Belza BL","year":"1995","journal-title":"J Rheumatol"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-7435(86)90037-X"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(97)00291-2"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.3.434"},{"key":"e_1_2_7_12_2","first-page":"283","article-title":"Fatigue in patients with systemic lupus erythematosus: the psychosocial aspects","volume":"30","author":"Omdal R","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1989.00520460115022"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-199005000-00005"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/32.12.1072"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.59.11.875"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1994.tb01629.x"},{"key":"e_1_2_7_18_2","first-page":"71","article-title":"Sleep disturbances, fibromyalgia and primary Sj\u00f6gren's syndrome","volume":"15","author":"Tishler M","year":"1997","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_19_2","first-page":"313","article-title":"Fatigue and health profile in sicca syndrome of Sj\u00f6gren's and non\u2010Sj\u00f6gren's syndrome origin","volume":"19","author":"Tensing EK","year":"2001","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_20_2","first-page":"2351","article-title":"Psychological and somatic predictors of perceived and measured ocular dryness of patients with primary Sj\u00f6gren's syndrome","volume":"32","author":"Vriezekolk JE","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330203"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"e_1_2_7_25_2","first-page":"1450","article-title":"A study of fatigue in SLE","volume":"17","author":"Krupp LB","year":"1990","journal-title":"J Rheumatol"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1191\/1352458502ms839oa"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008960710415"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.23113"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh170"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1080\/03009740510026571"},{"key":"e_1_2_7_31_2","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The Center for Epidemiologic Studies Scale for Depression: a self\u2010report depression scale for research in the general population","volume":"3","author":"Radloff LS","year":"1977","journal-title":"Appl Psychol Meas"},{"key":"e_1_2_7_32_2","first-page":"866","article-title":"A brief measure of helplessness in rheumatic disease: the helplessness subscale of the Rheumatology Attitudes Index","volume":"20","author":"DeVellis RF","year":"1993","journal-title":"J Rheumatol"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1191\/0961203302lu156oa"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-4541-9"},{"key":"e_1_2_7_35_2","first-page":"1407","article-title":"The prevalence and meaning of fatigue in rheumatic disease","volume":"23","author":"Wolfe F","year":"1996","journal-title":"J Rheumatol"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1191\/096120300678828046"},{"key":"e_1_2_7_37_2","first-page":"1699","article-title":"Fatigue in systemic lupus erythematosus: contributions of disease activity, pain, depression, and perceived social support","volume":"32","author":"Jump RL","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_7_38_2","first-page":"892","article-title":"Fatigue in lupus is not correlated with disease activity","volume":"25","author":"Wang B","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_7_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310708"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310503"},{"key":"e_1_2_7_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/32.7.633"},{"key":"e_1_2_7_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.11.1249"},{"key":"e_1_2_7_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem004"},{"key":"e_1_2_7_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.01857.x"},{"key":"e_1_2_7_45_2","first-page":"1355","article-title":"Musculoskeletal pain and fatigue are associated with chronic hepatitis C: a report of 239 hepatology patients","volume":"94","author":"Barkhuizen A","year":"1999","journal-title":"Gastroenterology"},{"issue":"9","key":"e_1_2_7_46_2","first-page":"S185","article-title":"Dimensions of fatigue in SLE: relationship to disease activity, behavioral and psychosocial factors","volume":"48","author":"Da Costa D","year":"2003","journal-title":"Arthritis Rheum"},{"key":"e_1_2_7_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(02)00312-X"},{"key":"e_1_2_7_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(01)00315-8"},{"key":"e_1_2_7_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010915)92:6 <1664::AID-CNCR1494>3.0.CO;2-9"},{"issue":"9","key":"e_1_2_7_50_2","first-page":"S446","article-title":"Over\u2010expression of interferon\u2010inducible genes is highly correlated with sicca manifestations and autoantibody levels in Sj\u00f6gren's syndrome","volume":"50","author":"Emamian ES","year":"2004","journal-title":"Arthritis Rheum"},{"key":"e_1_2_7_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(01)01679-2"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.24311","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.24311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T15:08:05Z","timestamp":1697123285000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.24311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,11,26]]},"references-count":50,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2008,12,15]]}},"alternative-id":["10.1002\/art.24311"],"URL":"https:\/\/doi.org\/10.1002\/art.24311","archive":["Portico"],"relation":{},"ISSN":["0893-7524","1529-0123"],"issn-type":[{"value":"0893-7524","type":"print"},{"value":"1529-0123","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,11,26]]}}}