title: Fatigue and depression in children with multiple sclerosis and monophasic variants.
abstract: BACKGROUND
  Fatigue is an important symptom in adult multiple sclerosis (MS) and it is likely to occur in children with MS. It is currently unknown whether children who experienced a monophasic inflammatory demyelinating event of the central nervous system in the past also suffer from fatigue.
  
  
  METHODS
  We studied the presence and severity of fatigue in 32 children (18 boys, 14 girls) between 11-17 years old (mean: 14 years, 10 months) with a monophasic inflammatory demyelinating disease (n=22) or definite MS (n=10). This was measured with the Checklist Individual Strength. A score of >or=40 on the severity of fatigue subscale indicated the presence of severe fatigue. We also examined the relation between fatigue and depression (assessed by the Child Depression Inventory). Additionally we measured the health-related quality of life (HRQoL), using the TNO-AZL Child Quality of Life child form. We compared the scores of the MS and monophasic patients with the scores of healthy Dutch children.
  
  
  RESULTS
  The highest scores on the fatigue scales subjective fatigue and physical activity were found in the children with MS. Only 1 of the monophasic patients suffered from severe fatigue in contrast to 4 of the MS patients. In the MS group fatigue and depression were correlated. MS patients experienced a lower HRQoL on the scales locomotor functioning, cognitive functioning and interaction with peers.
  
  
  CONCLUSIONS
  The occurrence of fatigue is very rare after a monophasic inflammatory demyelinating event in the past. As expected, fatigue occurs more frequent in paediatric MS patients.
authors.affiliation: Department of Neurology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Immy A
authors.initials: IA
authors.lastname: Ketelslegers
authors.forename: Coriene E
authors.initials: CE
authors.lastname: Catsman-Berrevoets
authors.forename: Maartje
authors.initials: M
authors.lastname: Boon
authors.forename: M Judith
authors.initials: MJ
authors.lastname: Eikelenboom
authors.forename: Hans
authors.initials: H
authors.lastname: Stroink
authors.forename: Rinze F
authors.initials: RF
authors.lastname: Neuteboom
authors.forename: Femke K
authors.initials: FK
authors.lastname: Aarsen
authors.forename: Elise M
authors.initials: EM
authors.lastname: van de Putte
authors.forename: Rogier Q
authors.initials: RQ
authors.lastname: Hintzen
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D003863:Depression / Q000209:etiology* / Q000523:psychology*; D004185:Disability Evaluation; D005221:Fatigue / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires