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Psychosocial correlates of fatigue in multiple sclerosis

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      Abstract

      Objective: To explore: (1) the interrelation among the neuropsychological, psychological, and psychosocial factors and fatigue as measured by the Multidimensional Assessment of Fatigue scale, and (2) the impact of fatigue on role performance.
      Design: Clinical interview with neuropsychological testing and cross-sectional study by mail.
      Setting: Multiple sclerosis (MS) clinic registry of a large Boston teaching hospital.
      Patients; 139 MS patients representing a broad range of disability.
      Main Outcome Measures: The Multidimensioanl Assessment of Fatigue (MAF) scale, the Extended Disability Status Scale, the Sickness Impact Profile, Rao cognitive battery, the Trailmaking Test, depression, anxiety, and social activity limitations subscales from the Arthritis Impact Measurement Scales, and the Ryff Happiness Scale.
      Results: Stepwise multiple regression analyses revealed that having a low sense of environmental mastery was the best psychosocial predictor of both global fatigue and fatigue-related distress, after adjusting for sociodemographic and medical factors. Further, people who reported being more depressed tended to report more severe fatigue. Neuropsychological performance was not associated with fatigue. Fatigue was found to limit social, work, and overall role performance, but not physical role performance.
      Conclusions: People who feel that they can choose or create environments suitableto their psychic or physical conditions report less global fatigue and less fatigue-related distress, and fatigue can have an important impact on role performance. The implications of these findings for designing fatigue management interventions are discussed.
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      References

        • Monks J
        Experiencing symptoms in chronic illness: fatigue in multiple sclerosis.
        Int Disabil Stud. 1989; 11: 78-83
        • Krupp LB
        • Alvarez LA
        • Larocca NG
        • Scheinberg LC
        Fatigue in multiple sclerosis.
        Arch Neurol. 1988; 45: 435-437
        • Murray TJ
        Amantadine therapy for fatigue in multiple sclerosis.
        Can J Neurol Sci. 1985; 12: 251-254
        • Freal JE
        • Kraft GH
        • Coryell JK
        Symptomatic fatigue in multiple sclerosis.
        Arch Phys Med rehabil. 1984; 65: 135-138
        • Edgley K
        • Sullivan M
        • Dehoux E
        A survey of multiple sclerosis: II. Determinants of employment status.
        Can J Rehabil. 1991; 4: 127-132
        • Jackson MF
        • Quaal C
        • Reeves MA
        Effects of multiple sclerosis on occupational and career patterns.
        Axon. 1991; (Sept.): 16-22
        • Ivers RR
        • Goldstein NP
        Multiple sclerosis: current appraisal of signs and symptoms.
        Mayo Clin Proc. 1963; 38: 457-466
        • Schapiro RT
        • Harris L
        • Lenling M
        • Metelak J
        Fatigue.
        in: Schapiro rT Symptom Management in Multiple Sclerosis. Demos Publications, New York1987
        • American Psychiatric Association
        2nd ed. Diagnostic and Statistical Manual of Mental Disorders-Revised. American Psychiatric Association, Washington, DC1987
        • The Canadian Research Group
        A randomized controlled trial of amantadine in fatigue associated with multiple sclerosis.
        Can J Neurol Sci. 1987; 14: 273-278
        • Cohen RA
        • Fisher M
        Amantadine treatment of fatigue associated with multiple sclerosis.
        Arch Neurol. 1989; 46: 676-680
        • Scheinberg L
        • Holland N
        • LaRocca N
        • Laitin P
        • Bennett A
        • Hall H
        Multiple sclerosis: earning a living.
        NY State J Med. 1980; 80: 1395-1400
        • Weinshenker BG
        • Penman M
        • Bass B
        • Ebers GC
        • Rice GPA
        A double-blind, randomized, crossover trial of pemoline in fatigue associated with multiple sclerosis.
        Neurology. 1992; 42: 1468-1471
        • Krupp LB
        • LaRocca NG
        • Muir-Nash J
        • Steinberg AD
        The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus.
        Arch Neurol. 1989; 46: 1121-1123
        • Amato M
        • Fratiglioni L
        • Groppi C
        • Siracusa G
        • Amaducci L
        Interrater reliability in assessing functional systems and disability on the Kurtzke scale in multiple sclerosis.
        Arch Neurol. 1988; 45: 746-748
        • Noseworthy JH
        • Vandervoort MK
        • Wong CJ
        • Ebers GC
        • Canadian Cooperative MS Study Group
        Interrater variability with the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) in a multiple sclerosis clinical trial.
        Neurology. 1990; 40: 971-975
        • Pepper CM
        • Krupp LB
        • Friedberg F
        • Doscher C
        • Coyle PK
        A comparison of neuropsychiatric characteristics in chronic fatigue syndrome, multiple sclerosis and major depression.
        J Neuropsychiatry Clin Neurosci. 1993; 5: 200-205
        • Minden SL
        • Moes EJ
        • Orav J
        • Kaplan E
        • Reich P
        Memory impairment in multiple sclerosis.
        J Clin Exp Neuropscyhol. 1990; 12: 566-586
        • Van den Berg W
        • Van Zomeren AH
        • Minderhoud JM
        • Prange AJA
        • Meijer NSA
        Cognitive impairment in patients with multiple sclerosis and mild physical disability.
        Arch Neurol. 1987; 44: 494-501
        • Sandroni P
        • Walker C
        • Starr A
        “Fatigue” in patients with multiple sclerosis: motor pathway conduction and event-related potentials.
        Arch Neurol. 1992; 49: 517-524
        • Jennekens-Schinkel A
        • Sanders EACM
        • Lanser JBK
        • Van der Velde EA
        Reaction time in ambulant multiple sclerosis patients, I: influence of prolonged cognitive effort.
        J Neurol Sci. 1988; 85: 173-186
        • Kurtzke JF
        Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).
        Neurology. 1983; 33: 1444-1452
        • Schwartz CE
        • Rogers M
        Designing a psychosocial intervention to teach coping flexibility.
        Rehabilitation Psychology. 1994; 39: 61-76
        • Belza BL
        • Henke CJ
        • Yelin EH
        • Epstein WV
        • Gilliss CL
        Correlates of fatigue in older adults with rheumatoid arthritis.
        Nurs Res. 1993; 42: 93-99
        • Rao SM
        • Leo GJ
        • Haughton VM
        • Aubin-Faubert P
        • Bernardin L
        Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis.
        Neurology. 1989; 39: 161-166
        • Rao SM
        • Leo G
        • Bernardin L
        • Unverzagt F
        Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction.
        Neurology. 1991; 41: 685-691
        • Rao SM
        • Leo G
        • Ellington L
        • Nauertz T
        • Bernardin L
        • Unverzagt F
        Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning.
        Neurology. 1991; 41: 692-696
      1. Army Individual Test Battery. 2nd ed. Manual of Directions and Scoring. War Department, Adjutant General's Office, Washington, DC1944
        • Buschke H
        • Fuld PA
        Evaluating storage, retention, and retrieval in disordered memory and learning.
        Neurology. 1974; 24: 1019-1025
        • Smith A
        Symbol Digit Modalities Test.
        (revised) Western Psychological Services, Los Angeles1982
        • Reitan R
        Validity of the Trail-Making Test as an indication of organic brain damage.
        Perceptual Motor Skills. 1958; 8: 271-276
        • Pollard WE
        • Bobbitt RA
        • Bergner M
        • Martin DP
        • Gilson BS
        The Sickness Impact Profile: reliability of a health status measure.
        Medical Care. 1976; 14: 146-155
        • Bergner M
        • Bobbitt RA
        • Carter WB
        • Gilson BS
        The Sickness Impact Profile: development and final revision of a health status measure.
        Medical Care. 1981; 19: 787-805
        • Meenan RF
        • Gertman PM
        • Mason JM
        Measuring health status in arthritis: the Arthritis Impact Measurement Scales.
        Arthritis Rheum. 1980; 23: 146-152
        • McDowell I
        • Newell C
        Measuring health.
        in: 2nd ed. A guide to rating scale and questionnaires. Oxford University Press, New York1987
        • Ryff CD
        Happiness is everything, or is it?.
        in: Explorations on the meaning of psychological well-being. 2nd ed. J Pers Soc Psychol. 57. 1989: 1069-1081
        • Schwartz CE
        • Fox BH
        Who says yes?.
        in: Identifying selection biases in a psychosocial intervention study of multiple sclerosis. 2nd ed. Soc Sci Med. 40. 1995: 359-370 (3)
        • Confavreux C
        • Aimard G
        • Devic M
        Course and prognosis of multiple sclerosis assessed by the computerized data processing of 349 patients.
        Brain. 1980; 103: 281-300
        • Matthews WB
        • Compston A
        • Allen IV,
        • Martyn CN
        McAlpine's multiple sclerosis.
        2nd ed. Churchill Livingstone, New York1991
        • Minden SL
        • Marder WD
        • Harrold LN
        • Dor A
        Multiple sclerosis: a statistical portrait.
        National Multiple Sclerosis Society, New York1993
        • Foley FW
        • Bedell JR
        • LaRocca NG
        • Scheinberg LC
        Efficacy of stress-inoculation training in coping with multiple sclerosis.
        J Consult Clin Psychol. 1987; 55: 919-922
        • Fischer JS
        • Foley FW
        • Aikens JE
        • Ericson GD
        • Rao SM
        • Shindell S
        What do we really know about cognitive dysfunction, affective disorders, and stress in multiple sclerosis?.
        in: A practitioner's guide. 2nd ed. J Neurol/Rehabil. 8. 1994: 151-164
        • Wexler BE
        • Cicchetti DV
        The outpatient treatment of depression: implications of outcome research for clinical practice.
        J Nerv Ment Dis. 1992; 180: 277-286