Inflammation as a key factor associated with kinesiophobia in a systemic lupus erythematosus patient population with a high frequency of Type D personality and central sensitization: a cross-sectional study.

To investigate the clinical, psychological, and functional determinants of kinesiophobia and to examine their interrelationships in patients with systemic lupus erythematosus (SLE). This cross-sectional study included 60 patients with SLE. Demographic characteristics, disease-related variables, laboratory parameters [e.g., C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)] and disease activity were recorded. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK). Central sensitization, personality, mental health, quality of life, and sleep were evaluated by the Central Sensitization Inventory (CSI), Type D Scale-14 (DS14), Hospital Anxiety and Depression Scale (HADS), Short Form-12 (SF-12), and Jenkins Sleep Evaluation Scale (JSS), respectively. Serial multiple mediation analysis were performed to examine factors associated with kinesiophobia. A mean age of patients with SLE was 39.7 ± 13.8 years. Kinesiophobia was present in 70% of the study population. Patients with kinesiophobia had significantly higher ESR and CRP, DS14 total and negative affectivity scores, and greater psychological distress across all HADS subscales (p < 0.05, for all). TSK scores correlated positively with CRP, ESR, pain, CSI, DS14, and HADS subscales (correlation coefficients ranged between 307 and 522) and negatively with SF-12 Physical Component Summary score (correlation coefficient=-0.414). Serial mediation analysis explained 40% of TSK score variance (R²=0.40). CRP had a significant direct effect on kinesiophobia (B = 0.87, p = 0.002), independent of age and sex. Neither DS14 nor CSI significantly mediated this association. Kinesiophobia is highly prevalent in patients with SLE and associated with inflammatory, psychological, and functional parameters. Systemic inflammation, reflected by CRP, appears to be independently associated with fear of movement in SLE. These findings underscore the importance of monitoring inflammatory markers in SLE management and integrating personality and central sensitization assessments into a comprehensive biopsychosocial approach.