Psychosocial correlates of fatigue in multiple sclerosis.
OBJECTIVE
To explore: (1) the interrelation among the neuropsychological, psychological, and psychosocial factors and fatigue as measured by the Multidimensional Assessment of Fatigue scale, and (2) the impact of fatigue on role performance.


METHODS
Clinical interview with neuropsychological testing and cross-sectional study by mail.


METHODS
Multiple sclerosis (MS) clinic registry of a large Boston teaching hospital.


METHODS
139 MS patients representing a broad range of disability.


METHODS
The Multidimensional Assessment of Fatigue (MAF) scale, the Extended Disability Status Scale, the Sickness Impact Profile, Rao cognitive battery, the Trailmaking Test, depression, anxiety, and social activity limitations subscales from the Arthritis Impact Measurement Scales, and the Ryff Happiness Scale.


RESULTS
Stepwise multiple regression analyses revealed that having a low sense of environmental mastery was the best psychosocial predictor of both global fatigue and fatigue-related distress, after adjusting for sociodemographic and medical factors. Further, people who reported being more depressed tended to report more severe fatigue. Neuropsychological performance was not associated with fatigue. Fatigue was found to limit social, work, and overall role performance, but not physical role performance.


CONCLUSIONS
People who feel that they can choose or create environments suitable to their psychic or physical conditions report less global fatigue and less fatigue-related distress, and fatigue can have an important impact on role performance. The implications of these findings for designing fatigue management interventions are discussed.
Schwartz
C E
CE
Rocky Mountain MS Center, Englewood, CO, USA.
Coulthard-Morris
L
L
Zeng
Q
Q
D000203:Activities of Daily Living; D000328:Adult; D003430:Cross-Sectional Studies; D004777:Environment; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D012380:Role; D011795:Surveys and Questionnaires