Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren's syndrome

Kate L. Hackett, Kristen Davies, Jessica Tarn, Rebecca Bragg, Ben Hargreaves, Samira Miyamoto, Peter McMeekin, Sheryl Mitchell, Simon Bowman, Elizabeth J. Price, Colin Pease, Paul Emery, Jacqueline Andrews, Peter Lanyon, John Hunter, Monica Gupta, Michele Bombardieri, Nurhan Sutcliffe, Costantino Pitzalis, John McLarenAnnie Cooper, Marian Regan, Ian Giles, David Isenberg, Saravan Vadivelu, David Coady, Bhaskar Dasgupta, Neil McHugh, Steven Young-Min, Robert Moots, Nagui Gendi, Mohammed Akil, Bridget Griffiths, Dennis W. Lendrem, Wan Fai Ng

Research output: Contribution to journalArticle

1 Citation (Scopus)


Objectives To report on fatigue in patients from the United Kingdom primary Sjögren's syndrome (pSS) registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness. Methods From our cohort (n = 608), we identified those with comorbidities associated with fatigue, and those taking medications associated with drowsiness. We constructed dummy variables, permitting the contribution of these potentially assignable causes of fatigue to be assessed. Using multiple regression analysis, we modelled the relationship between Profile of Fatigue and Discomfort physical and mental fatigue scores and potentially related variables. Results Pain, depression and daytime sleepiness scores were closely associated with both physical and mental fatigue (all p ≤ 0.0001). In addition, dryness was strongly associated with physical fatigue (p ≤ 0.0001). These effects were observed even after adjustment for comorbidities associated with fatigue or medications associated with drowsiness. Conclusions These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in patients with pSS. This finding is robust to both the effect of other comorbidities associated with fatigue and medications associated with drowsiness.

Original languageEnglish
Article numbere000885
Pages (from-to)1-7
Number of pages7
JournalRMD Open
Issue number1
Publication statusPublished - 24 Apr 2019


  • comorbidities
  • concomitant medications
  • depression
  • fatigue
  • pain
  • Sjogren's syndrome

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Hackett, K. L., Davies, K., Tarn, J., Bragg, R., Hargreaves, B., Miyamoto, S., McMeekin, P., Mitchell, S., Bowman, S., Price, E. J., Pease, C., Emery, P., Andrews, J., Lanyon, P., Hunter, J., Gupta, M., Bombardieri, M., Sutcliffe, N., Pitzalis, C., ... Ng, W. F. (2019). Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren's syndrome. RMD Open, 5(1), 1-7. [e000885].