Fatigue May Predict Depression, Joint Involvement in Psoriatic Disease

HealthDay News — Patients with psoriatic arthritis have higher levels of fatigue than patients with psoriasis treated with phototherapy or systemic treatment, according to a research letter published online Dec. 22 in the British Journal of Dermatology.

Anne-Marie Tobin, MBBCh, from Adelaide and Meath Hospital Incorporating National Children’s Hospital in Dublin, and colleagues conducted a prospective observational study to examine levels of fatigue among 103 patients with psoriasis prior to commencing phototherapy, 97 with psoriasis attending the systemic clinic, and 100 diagnosed with psoriatic arthritis by a rheumatologist.

The researchers found that the mean fatigue scores, measured using a visual analogue scale (VAS), were relatively low in all groups: 2.0, 3.4, and 3.9 for the phototherapy, systemic treatment, and psoriatic arthritis groups, respectively. Severe fatigue occurred in 11%, 21%, and 31% of phototherapy patients, systemic clinic attendees, and patients with psoriatic arthritis. Higher levels of fatigue were seen for patients with psoriatic arthritis versus those with psoriasis receiving phototherapy or systemic treatment (P =.009). Across all groups, female patients reported higher levels of fatigue than male patients (P =.0001). Fatigue scores were correlated with depression scores, but not with anxiety scores, in the Hospital Anxiety and Depression Scales.

“The VAS-Fatigue may be a predictor of depression in female patients or incipient joint involvement in patients with psoriasis and is a simple tool to implement in clinical practice,” the authors wrote.

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Tobin AM, Sadlier M, Collins P, Rogers S, FitzGerald O, Kirby B. Fatigue as a symptom in psoriasis and psoriatic arthritis: an observational study. Br J Dermatol. 2016; doi:10.1111/bjd.15258.