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The measurement of fatigue in patients with multiple sclerosis. A multidimensional comparison with patients with chronic fatigue syndrome & healthy subjects

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OBJECTIVE: To provide a multidimensional characterization of
fatigue in patients with multiple sclerosis (MS).

DESIGN:Cross-sectional design. Fifty patients with clinically
definiteMS were compared on the dimensions of fatigue with
51 patientswith chronic fatigue syndrome (CFS) and 53
healthy subjects.

RESULTS: Fourty-six percent of the patients
with MS reportedfatigue to be present at least once a week.
Patients with MS andpatients with CFS had significantly
higher subjective fatigueseverity scores than healthy
subjects. Patients with MS andpatients with CFS had
significantly higher scores on measures ofpsychological
well-being than healthy subjects. Patients with MShad scores
similar to those of patients with CFS, except thatpatients
with CFS had significantly higher somatization scores.High
somatization scores reflect strong focusing on bodily
sensations. Both groups of patients were significantly less
active than the healthy subjects. The Kurtzke Expanded
DisabilityStatus Scale (EDSS) and the Beck Depression
Inventory scores werenot related to subjective fatigue
severity. In patients with MSand in patients with CFS,
subjective fatigue severity was relatedto impairment in
daily life, low sense of control over symptoms,and strong
focusing on bodily sensations. In CFS, but not in MS,
evidence was found for a relationship between low levels of
physical activity and attributing symptoms to a physical cause
and between subjective fatigue severity and physical
activity.

CONCLUSIONS: Patients with MS experienced
significant fatigue,which had a significant impact on daily
functioning and was notrelated to depression on Expanded
Disability Status Scale score.Psychological factors, such as
focusing on bodily sensations andlow sense of control play a
role in the experience of fatigue inMS and CFS.

MCM: Compared 50 pts w definite MS to 51 w CFS and 53 Normals.
Pts w MS and CFS had significantly higher subjective fatigue
than normals, worse subjective well-being (but CFS had higher
scores for somatization, lower activity.The BDI depression
scores were not related to subjective fatigue activity.
Subjectve fatigue in both groups was related to impairment in
daily life, low sense of control over symptoms, and strong
focusing on bodily sensations.In CFS, but not MS, evidence
was found for a relationship between low levels of physical
activity and attributing symptoms to a physical cause and
between subjective fatigue severity and physical activity.

Vercoulen JH, Hommes OR, Swanink CM, Jongen PJ, Fennis JF, Galama
JM, van der Meer JW, Bleijenberg G

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