Toward an understanding of different manifestations of fatigue

Goetz, Stefan M.; Koch, Thomas; Hahr, Marion; Beer, Christine; Minder, Christoph E.; Adler, Rolf H.

doi:10.1016/j.jpsychores.2004.08.008

« Previous Next »Journal of Psychosomatic Research
Volume 58, Issue 2 , Pages 179-182, February 2005

Toward an understanding of different manifestations of fatigue

Stefan M. Goetz
- Medical Division Lory, University of Berne, Berne 3010, Switzerland
- Corresponding author. Leiter a.i. Geriatrie/Rehabilitation, Medizinische Abteilung C.L. Lory-Haus, KAIM, Inselspital, Bern CH-3010, Switzerland. Tel.: +41 31 632 20 19; fax: +41 31 382 11 84.
Thomas Koch
- Medical Division Lory, University of Berne, Berne 3010, Switzerland
Marion Hahr
- Medical Division Lory, University of Berne, Berne 3010, Switzerland
Christine Beer
- Medical Division Lory, University of Berne, Berne 3010, Switzerland
Christoph E. Minder
- Biostatistical Division, Department of Social and Preventive Medicine, University of Berne, Bern 3012, Switzerland
Rolf H. Adler
- Medical Division Lory, University of Berne, Berne 3010, Switzerland

Received 29 October 2003; accepted 17 August 2004.

Abstract

Background

The aim of this study was to determine if patient narratives and interviewer reactions are specific in groups of somatic (SF) and psychogenic fatigue (PF) patients.

Methods

The interview criteria and criteria of the interviewer reaction are tested against group classification. Over a 2-year period, 51 (22 PF and 29 SF) patients fulfilling the inclusion criteria were interviewed by two trained independent interviewers. The tape-recorded interviews were analyzed and blind rated by a set of independent physicians. State and Trait Anxiety Inventories (STAI and TRAI, respectively), Beck Depression Inventory (BDI), and Beck's hopelessness scales were completed by the patients.

Results

SF versus PF patients more often showed a clear versus vague qualitative description (P=.03), clear changes in levels of intensity (P=.03), and clear factors contributing to the increase (P=.02) and decrease (P=.03) of fatigue. In SF, the raters more often felt calm (P=.03), interested (P=.01), and attentive (P=.02). With PF tapes, the raters more often felt impatient (P=.03), surprised (P=.03), and helpless (P=.01). For the TRAI, the mean score of the PF group was significantly higher compared with that of the SF group (P=.004). For all items, Fisher's Exact Test was used.

Conclusions

Our results confirm significant differences in patient narratives and interviewer reactions for the groups examined. The systematic use of interview criteria and analysis of the interviewer reactions may contribute to the better understanding of fatigue.

Keywords: Fatigue, Depression, Interview criteria, Interviewer reaction, Hopelessness, Patient's narrative, State and trait anxiety