The contribution of disease severity, depression and negative affectivity to fatigue in multiple sclerosis: A comparison with ulcerative colitis
Received 1 July 2009; received in revised form 19 November 2009; accepted 30 November 2009. published online 22 January 2010.
Abstract
Background
Fatigue is one of the most common and troubling symptoms of multiple sclerosis (MS) and more severe and disabling than fatigue in other somatic populations. Although fatigue seems MS specific, its pathogenesis is still poorly understood.
Objective
To study the disease specificity of fatigue in MS by comparing its level, its physical and psychological correlates to those of patients with ulcerative colitis (UC), a peripheral chronic auto-immune disease. We focused on the relative contribution of disease severity, depression and negative affectivity to fatigue in both patient samples.
Methods
A total of 88 MS and 76 UC patients were included in this cross-sectional study. Fatigue, depression and negative affectivity were assessed respectively with the physical and mental fatigue subscales of the Multidimensional Fatigue Inventory, the depression subscale of the Hospital Anxiety and Depression Scale, and the neuroticism subscale of the Dutch NEO Five-Factor Inventory. The Expanded Disability Status Scale and the Colitis Activity Index were used to measure disease severity in MS and UC patients respectively.
Results
While levels of both physical and mental fatigue were significantly higher in MS patients than in UC patients, there were no group differences in the contribution of disease severity, depression and negative affectivity to both physical and mental fatigue.
Conclusion
Although levels of fatigue are higher for MS patients when compared with UC patients, the correlates of fatigue do not indicate MS specificity. As such our results support a transdiagnostic approach to fatigue in MS.
aDepartment of Medical Psychology and Psychiatry, Orbis Medical Centre, Sittard, The Netherlands
bSchool for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
cDepartment of Neurology, Orbis Medical Centre, Sittard, The Netherlands
dDepartment of Internal Medicine, Orbis Medical Centre, Sittard, The Netherlands
eDepartment of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
fDepartment of Psychology, University of Leuven, Leuven, Belgium
Corresponding author. Department of Medical Psychology and Psychiatry, Orbis Medical Centre, PO Box 5500, 6130 MB Sittard, The Netherlands. Tel.: +31 884597837; fax: +31 884591491.
ABSTRACT