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      Fatigue, depression, and physical impairment in multiple sclerosis

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          Abstract

          Background: Fatigue, depression, and physical impairment are common among multiple sclerosis (MS) patients. The aim of this study was to determine the relationship between depression, physical impairment, and fatigue in an Iranian MS cohort.

          Methods: Fifty consecutive relapsing-remitting MS patients and 50 age- and sex-matched healthy controls (HCs) were recruited from Sina Rehabilitation Clinic, Tehran, Iran. The depression substance of Hospital Anxiety and Depression Scale (HADS), Expended Disability Status Scale, and Fatigue Severity Scale questionnaires were used to assess depression, physical impairment, and fatigue, respectively.

          Results: This study included 38 (76%) females and 12 (24%) males in both patients and HC groups. The depression substance of the HADS in MS and HCs showed a mean value of 1.92 ± 0.80 and 1.17 ± 0.38, respectively (P < 0.001). Pearson’s correlation analyses showed that in the MS group depression was associated with fatigue (r = 0.54, P = 0.01), but not with physical impairment (r = 0.16, p = 0.01), while fatigue was associated with both depression (r = 0.54, P = 0.01) and physical impairment (r = 0.36, P = 0.01). Depression in HCs group was also associated with fatigue (r -0.64, P = 0.01).

          Conclusion: Fatigue is associated with both depression and physical impairment, and an intervention in one of these conditions might improve others.

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          Most cited references11

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          The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version

          Background The Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients. This study aimed to translate and test the reliability and validity of the Iranian version of the HADS. Methods The English language version of the HADS was translated into Persian (Iranian language) and was used in this study. The questionnaire was administered to a consecutive sample of 167 breast cancer patients and statistical analysis was performed to test the reliability and validity of the HADS. Results In general the Iranian version of the HADS was found to be acceptable to almost all patients (99%). Cronbach's alpha coefficient (to test reliability) has been found to be 0.78 for the HADS anxiety sub-scale and 0.86 for the HADS depression sub-scale. Validity as performed using known groups comparison analysis showed satisfactory results. Both anxiety and depression sub-scales discriminated well between sub-groups of patients differing in clinical status as defined by their disease stage. Conclusion This preliminary validation study of the Iranian version of the HADS proved that it is an acceptable, a reliable and valid measure of psychological distress among cancer patients.
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            Fatigue in multiple sclerosis is related to disability, depression and quality of life.

            Fatigue in multiple sclerosis is a frequent and disabling symptom that can interfere in daily functioning. The aim of this study is to demonstrate the relationship between fatigue and disability, disease course, depression and quality of life. We administered French valid versions of the Fatigue Impact Scale (EMIF-SEP), the short form of the Beck depression inventory (13 items) and the SF-36 to 237 out of 312 patients with clinically definite multiple sclerosis with EDSS
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              Fatigue in multiple sclerosis: relation to depression, physical impairment, personality and action control.

              Although fatigue is one of the most common symptoms of multiple sclerosis, it is yet poorly understood and therefore difficult to manage. To clarify the nature of fatigue we investigated its relationship to depression, physical impairment, personality and action control and compared these variables between a sample of 41 MS patients and 41 healthy controls. Physical impairment was assessed by the EDSS and all other dimensions, using questionnaires. Stepwise linear regression analyses revealed that physical impairment was related to physical fatigue in MS patients. Depression was the main factor influencing fatigue among both, MS patients and controls. What clearly differentiated the two groups was the correlation between fatigue and action control. Decreased levels of action control imply attentional and motivational deficits and were only found in fatigued MS patients. Our study indicates that motivational disturbances might be specific for MS related fatigue.
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                Author and article information

                Journal
                Iran J Neurol
                Iran J Neurol
                IJNL
                Iranian Journal of Neurology
                Iranian Neurological Association (Tehran, Iran )
                2008-384X
                2252-0058
                3 April 2014
                : 13
                : 2
                : 105-107
                Affiliations
                [1 ]Department of Clinical Sciences, School of Medicine, Tehran University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
                [2 ]Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
                [3 ]Department of Medical Sciences, School of Medicine, Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Corresponding Author: Azam Shahvarughi Farahani ot_farahani@ 123456yahoo.com
                Article
                IJNL-13-105
                4187328
                57b94e57-ac05-43fa-ac74-84eaf7ff13dd
                Copyright © 2014 Iranian Neurological Association, and Tehran University of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 November 2013
                : 1 May 2014
                Categories
                Short Communication

                depression,fatigue,iran,multiple sclerosis,physical impairment

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