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Fatigue in multiple sclerosis: association with disease-related, behavioural and psychosocial factors

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada, daria.trojan{at}mcgill.ca

D. Arnold

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

J-P. Collet

Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada, Randomized Clinical Trial Unit, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

S. Shapiro

Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada, Randomized Clinical Trial Unit, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

A. Bar-Or

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

A. Robinson

Randomized Clinical Trial Unit, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

J-P. Le Cruguel

Randomized Clinical Trial Unit, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

T. Ducruet

Randomized Clinical Trial Unit, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

S. Narayanan

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

K. Arcelin

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

AN Wong

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

MC Tartaglia

Department of Neurology, University of Western Ontario, London, Ontario, Canada

Y. Lapierre

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

Z. Caramanos

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

D. Da Costa

Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

We determined biopsychosocial correlates of general, physical, and mental fatigue in MS patients, by evaluating the additional contribution of potentially modifiable factors after accounting for non-modifiable disease-related factors. Fifty-three ambulatory MS patients, along with 28 normal controls were recruited for a cross-sectional study. Subjects completed the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale. Potential correlates evaluated were: disease-related factors (disease duration and type, immunomodulating treatment, muscle strength, pain, forced vital capacity (FVC), respiratory muscle strength, body mass index, disability, fibromyalgia), behavioural factors (physical activity, sleep quality) and psychosocial factors (depression, stress, self-efficacy). Multivariate models were calculated for MFI General, Physical, and Mental Fatigue. Age-adjusted multivariate models with non-modifiable factors included the following predictors (P 0.10) of 1) MFI General and Mental Fatigue: none; and 2) MFI Physical Fatigue: FVC and disability. The following potentially modifiable predictors (P 0.10) made an additional contribution to the models 1) MFI General Fatigue: sleep quality, self-efficacy, pain; 2) MFI Physical Fatigue: self-efficacy, physical activity; and 3) MFI Mental Fatigue: stress, self-efficacy. Fatigue in MS is multidimensional. Correlates of general and physical fatigue are disease-related, behavioural and psychosocial factors. Correlates of mental fatigue are psychosocial factors. Potentially modifiable factors account for a considerable portion of fatigue. Multiple Sclerosis 2007; 13: 985—995. http://msj.sagepub.com

Key Words: biopsychosocial predictors • exercise • fatigue • multiple sclerosis • pain • self-efficacy • sleep disorders • stress

This version was published on September 1, 2007

Multiple Sclerosis, Vol. 13, No. 8, 985-995 (2007)
DOI: 10.1177/1352458507077175


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