Fatigue, Depression and Sleep Disturbances in Iranian Patients with Multiple Sclerosis
,
Abstract
Fatigue is one of the most frequent symptoms in patients with multiple sclerosis (MS) and it is difficult to clarify the nature of this symptom and manage it. This study was aimed to evaluate the frequency of fatigue, depression and sleep disturbances in Iranian patients with MS. 100 patients from the outpatient MS clinic of Sina hospital were asked to complete Beck Depression Inventory (BDI), Pittsburg Sleep Quality Index (PSQI), Sleep Disorder Questionnaire (SDQ), Modified Fatigue Impact Scale (MFIS) and Epworth Sleepiness Scale (ESS) questionnaires. Student's t-test, ANOVA, Spearman correlation and Stepwise multiple linear regressions by SPSS version 15.0 were used for data analysis. From participants, 64 had fatigue complaint during day time and 36 did not feel fatigued. BDI, PSQI, MFIS and SDQ scores were significantly higher in fatigued patients than non-fatigued group but there were no statistically significant differences in ESS, EDSS and duration of disease between fatigued and non-fatigued cases. There were significant correlations between MFIS and BDI scores (r=0.49, P=0.01), MFIS and PSQI scores (r=0.399, P=0.01) and MFIS and ESS (r=0.25, P=0.01). This study demonstrates that depression is not the only cause of fatigue in patients with MS and it is also associated with sleep disorders, so this complaint should be carefully evaluated and managed in these patients.
McFarlin DE, McFarland H F. Multiple Sclerosis. N Engl J Med 1982;307(20):1246-51.
Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 1983;13(3):227-31.
Kaynak H, Altintaş A, Kaynak D, Uyanik O, Saip S, Ağaoğlu J, Onder G, Siva A. Fatigue and sleep disturbance in multiple sclerosis. Eur J Neurol 2006;13(12):1333-9.
Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC. Fatigue in multiple sclerosis. Arch Neurol 1988;45(4):435-7.
Bergamaschi R, Romani A, Versino M, Poli R, Cosi V. Clinical aspects of fatigue in multiple sclerosis. Funct Neurol 1997;12(5):247-51.
MacAllister WS, Krupp LB. Multiple sclerosis-related fatigue. Phys Med Rehabil Clin N Am 2005;16(2):483-502.
Kos D, Kerckhofs E, Nagels G, D'hooghe MB, Ilsbroukx S. Origin of fatigue in multiple sclerosis: review of the literature. Neurorehabil Neural Repair 2008;22(1):91-100.
Iriarte J, Subirá ML, Castro P. Modalities of fatigue in multiple sclerosis: correlation with clinical and biological factors. Mult Scler 2000;6(2):124-30.
Ford H, Trigwell P, Johnson M. The nature of fatigue in multiple sclerosis. J Psychosom Res 1998;45(1):33-8.
Attarian HP, Brown KM, Duntley SP, Carter JD, Cross AH. The relationship of sleep disturbances and fatigue in multiple sclerosis. Arch Neurol 2004;61(4):525-8.
Minden SL, Schiffer RB. Affective disorders in multiple sclerosis. Review and recommendations for clinical research. Arch Neurol 1990;47(1):98-104.
Feinstein A. The neuropsychiatry of multiple sclerosis. Can J Psychiatry 2004;49(3):157-63.
Minden SL, Orav J, Reich P. Depression in multiple sclerosis. Gen Hosp Psychiatry 1987;9(6):426-34.
Möller A, Wiedemann G, Rohde U, Backmund H, Sonntag A. Correlates of cognitive impairment and depressive mood disorder in multiple sclerosis. Acta Psychiatr Scand 1994;89(2):117-21.
Pujol J, Bello J, Deus J, Martí-Vilalta JL, Capdevila A. Lesions in the left arcuate fasciculus region and depressive symptoms in multiple sclerosis. Neurology 1997;49(4):1105-10.
Chwastiak LA, Gibbons LE, Ehde DM, Sullivan M, Bowen JD, Bombardier CH, Kraft GH. Fatigue and psychiatric illness in a large community sample of persons with multiple sclerosis. J Psychosom Res 2005;59(5):291-8.
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(10):1121-3.
Möller A, Wiedemann G, Rohde U, Backmund H, Sonntag A. Correlates of cognitive impairment and depressive mood disorder in multiple sclerosis. Acta Psychiatr Scand 1994;89(2):117-21.
Stanton BR, Barnes F, Silber E. Sleep and fatigue inmultiple sclerosis. Mult Scler 2006;12(4):481-6.
Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persianlanguage version of the Beck Depression Inventory:Second edition: BDI-II-PERSIAN. Depress Anxiety 2005;21(4):185-92.
Bakshi R. Fatigue associated with multiple sclerosis: diagnosis, impact and management. Mult Scler 2003;9(3):219-27.
Douglass AB, Bornstein R, Nino-Murcia G, Keenan S, Miles L, Zarcone VP Jr, Guilleminault C, Dement WC. The Sleep Disorders Questionnaire. I: Creation and multivariate structure of SDQ. Sleep 1994;17(2):160-7.
Farrahi J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A). Sleep Breath 2009;13(3):259-62.
Penner IK, Bechtel N, Raselli C, Stöcklin M, Opwis K, Kappos L, Calabrese P. Fatigue in multiple sclerosis: relation to depression, physical impairment, personality and action control. Mult Scler 2007;13(9):1161-7.
Mohr DC, Hart SL, Goldberg A. Effects of treatment for depression on fatigue in multiple sclerosis. Psychosom Med 2003;65(4):542-7.
Alarcia R, Ara JR, Martín J, Bertol V, Bestué M. Importance and factors related to chronic fatigue in multiple sclerosis. Neurologia 2005;20(2):77-84.
Bakshi R, Shaikh ZA, Miletich RS, Czarnecki D, Dmochowski J, Henschel K, Janardhan V, Dubey N, Kinkel PR. Fatigue in multiple sclerosis and its relationship to depression and neurologic disability. Mult Scler 2000;6(3):181-5.
Vercoulen JH, Hommes OR, Swanink CM, Jongen PJ, Fennis JF, Galama JM, van der Meer JW, Bleijenberg G. The measurement of fatigue in patients with multiple sclerosis. A multidimensional comparison with patients with chronic fatigue syndrome and healthy subjects. ArchNeurol 1996;53(7):642-9.
Joffe RT, Lippert GP, Gray TA, Sawa G, Horvath Z. Mood disorder and multiple sclerosis. Arch Neurol 1987;44(4):376-8.
Codella M, Rocca MA, Colombo B, Martinelli-Boneschi F, Comi G, Filippi M. Cerebral grey matter pathology and fatigue in patients with multiple sclerosis: a preliminary study. J Neurol Sci 2002;194(1):71-4.
Tachibana N, Howard RS, Hirsch NP, Miller DH, Moseley IF, Fish D. Sleep problems in multiple sclerosis. Eur Neurol 1994;34(6):320-3.
Lobentanz IS, Asenbaum S, Vass K, Sauter C, Klösch G, Kollegger H, Kristoferitsch W, Zeitlhofer J. Factors influencing quality of life in multiple sclerosis patients: disability, depressive mood, fatigue and sleep quality. Acta Neurol Scand 2004;110(1):6-13.
Johnson SL. The concept of fatigue in multiple sclerosis. J Neurosci Nurs 2008;40(2):72-7.
Ferini-Strambi L, Filippi M, Martinelli V, Oldani A, Rovaris M, Zucconi M, Comi G, Smirne S. Nocturnal sleep study in multiple sclerosis: correlations with clinical and brain magnetic resonance imaging findings. J Neurol Sci 1994;125(2):194-7.
Patten SB, Metz LM. Fatigue and depression in multiple sclerosis. Can J Psychiatry 2000;45(1):84-5.
| Files | ||
| Issue | Vol 50, No 4 (2012) | |
| Section | Articles | |
| Keywords | ||
| MS Fatigue Depression Sleep disturbances Iran | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
