Azizoddin DR, et al. - Given that fatigue is common among people with systemic lupus erythematosus (SLE), however, causes are not well understood, researchers analyzed perceived stress and depressive symptoms as predictors of fatigue in SLE. They used information from two years of the Lupus Outcomes Study (n = 650), obtained through annual structured interviews. While initially depressive symptoms predicted subsequent fatigue, stress mediated the results. Furthermore, a decrease in stress was linked to a clinically significant decrease in fatigue. These outcomes suggest that perceived stress plays an important role in fatigue with SLE and can be a major focus of fatigue interventions. The addition of T1-T2 decrease in stress was related to a clinically meaningful decline in fatigue.