Fatigue and Associated Factors in an Immune-Mediated Inflammatory Disease Population: A Cross-Sectional Study

Fatigue is a main symptom of chronic diseases, including immune-mediated inflammatory diseases (IMIDs), such as inflammatory bowel disease (IBD) and inflammatory arthritis (IA); however, the pathophysiological mechanisms are not completely understood. The aim of this study was to assess the prevalence of fatigue and the associated factors in an IMIDs population. A control group, IBD, and IA patients, were enrolled. The PROMIS (R) fatigue questionnaire was used to evaluate the symptoms. Information on demographics, anthropometrics, disease characteristics, and medications was collected for each participant. A total of 471 subjects (137 with IBD, 103 with IA, and 206 controls) were enrolled. IBD and IA patients reported greater fatigue than controls (p < 0.001, each). In univariate regression, patients with anxiety and depression were more likely to report fatigue (p = 1.40 x 10(-9) and p = 3.80 x 10(-11), respectively). Males, holding a high school diploma, and being employed were inversely correlated to the domain (p = 1.3 x 10(-5); p = 0.003 and p = 0.005, respectively). The use of steroids and disease activity determined increased fatigue (p = 0.014 and p = 0.019; respectively). In the multivariate analysis, anxiety and depression remained associated (p = 0.002 and p = 1.3 x 10(-5), respectively). IMIDs patients present increased fatigue compared with healthy subjects. Anxiety and depression are the main associated factors, suggesting a psychological component of the symptom; thus, a holistic management should be established.

Automated summary

This study assessed the prevalence of fatigue and its associated factors in patients with immune-mediated inflammatory diseases (IMIDs). The results showed that anxiety and depression were the main factors associated with fatigue, suggesting a psychological component of the symptom. This highlights the need for a comprehensive management approach.