History of Affective Disorder and the Temporal Trajectory of Fatigue in Rheumatoid Arthritis

Authors

Judith Fifield Ph.D., The University of Connecticut School of Medicine
Julia McQuillan, University of Nebraska - LincolnFollow
Howard Tennen, The University of Connecticut School of Medicine
T. Joseph Sheehan, The University of Connecticut School of Medicine
Susan Reisine, The University of Connecticut School of Dental Medicine
Victor Hesselbrock, The University of Connecticut School of Medicine
Naomi Rothfield, The University of Connecticut School of Medicine

Date of this Version

February 2001

Comments

Published in Ann Behav Med 2001, 23(1):34–41. Copyright © 2001 by The Society of Behavioral Medicine. Used by permission.

Abstract

This study examines whether the general level and rate of change of fatigue over time is different for those rheumatoid arthritis (RA) patients with and those without a history of affective disorder (AD). Four hundred fifteen RA patients from a national panel had yearly telephone interviews to obtain fatigue and distress reports, and a one-time semistructured assessment of the history of depression and generalized anxiety disorder. Growth-curve analysis was used to capture variations in initial fatigue levels and changes in fatigue over 7 years for those with and without a history. RA patients with a history of major AD reported levels of fatigue that were 10% higher than those without a history in the 1st year of the study. Their fatigue reports remained elevated over 7 years. Further analysis showed that the effects of a history of AD on fatigue are fully mediated through current distress, although those with a history had a significantly smaller distress–fatigue slope. Thus, a history of AD leaves RA patients at risk for a 7-year trajectory of fatigue that is consistently higher than that of patients without a history. The elevation in fatigue reports is, at least in part, a function of enduring levels of distress.