title: High disease impact of myotonic dystrophy type 2 on physical and mental functioning.
abstract: The aim of the study was to investigate health status in patients with myotonic dystrophy type 2 (DM2) and determine its relationship to pain and fatigue. Data on health status (SF-36), pain (MPQ) and fatigue (CIS-fatigue) were collected for the Dutch DM2 population (n = 32). Results were compared with those of sex- and age-matched adult-onset myotonic dystrophy type 1 (DM1) patients. In addition, we compared the obtained scores on health status of the DM2 group with normative data of the Dutch general population (n = 1742). Compared to DM1, the SF-36 score for bodily pain was significantly (p = 0.04) lower in DM2, indicating more body pain in DM2. DM2 did not differ from DM1 on any other SF-36 scales. In comparison to the Dutch population, DM2 patients reported lower scores (indicating worse clinical condition) on the physical functioning, role functioning-physical, bodily pain, general health, vitality, social functioning, and role functioning-emotional scales (p < 0.01 on all scales). The difference was most profound for the physical functioning scale. In the DM2 group the severity of pain was significantly correlated with SF-36 scores for bodily pain (p = 0.003). Fatigue was significantly correlated with the SF-36 scores for role functioning-physical (p = 0.001), general health (p = 0.02), and vitality (p = 0.02). The impact of DM2 on a patients' physical, psychological and social functioning is significant and as high as in adult-onset DM1 patients. From the perspective of health-related quality of life, DM2 should not be considered a benign disease. Management of DM2 patients should include screening for pain and fatigue. Symptomatic treatment of pain and fatigue may decrease disease impact and help improve health status in DM2, even if the disease itself cannot be treated.
authors.affiliation: Department of Neurology, Neuromuscular Centre Nijmegen, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. a.tieleman@neuro.umcn.nl
authors.forename: Alide A
authors.initials: AA
authors.lastname: Tieleman
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Jenks
authors.forename: Joke S
authors.initials: JS
authors.lastname: Kalkman
authors.forename: George
authors.initials: G
authors.lastname: Borm
authors.forename: Baziel G M
authors.initials: BG
authors.lastname: van Engelen
mesh_terms: D000328:Adult; D000368:Aged; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020967:Myotonic Disorders / Q000150:complications*; D009223:Myotonic Dystrophy; D010146:Pain / Q000453:epidemiology* / Q000209:etiology*; D011788:Quality of Life; D011795:Surveys and Questionnaires