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Fatigue in multiple sclerosis: reciprocal relationships with physical disabilities and depression
Karlein M G Schreurs1, Denise T D de Ridder, Jozien M Bensing
1Department of Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands. k.schreurs@fss.uu.nl
Objective:
To explore relations of fatigue, physical disabilities, and depression in patients with multiple sclerosis (MS) cross-sectionally and over time.
Methods:
Ninety-eight MS patients were interviewed twice at an interval of a year. Relationships of physical and mental fatigue, and reduced activity and motivation with depression and physical disabilities were established cross-sectionally by regression analyses and longitudinally by structural equation modelling.
Results:
Cross-sectionally, physical fatigue was related with physical disabilities, and mental fatigue was associated with depression. Prospectively, physical fatigue was a predictor of the physical disabilities of a year later. The reverse relationship of physical disabilities predicting the physical fatigue of one year later was, however, not significant, while depression predicted this physical fatigue and reduced activity of a year later. Depression did not predict the later mental fatigue nor was depression predicted by preceding fatigue experiences.
Conclusions:
Fatigue in MS should be studied over time as relationships of fatigue with physical and mental health change during the course of a year. Moreover, differentiating in fatigue experiences sheds light on the relationship of fatigue with physical and mental health.