title: Fatigue, depression, and health-related quality of life in patients with multiple sclerosis in Isfahan, Iran.
abstract: OBJECTIVE
  Quality of life (QoL) of patients with multiple sclerosis (MS) is worse than that of other chronic diseases. There is a need to examine the impact of fatigue and depression on the QoL independent of level of physical disability in MS. The aim of this study is to explore physical, psychological, and social aspects of health-related QoL (HRQoL) of MS patients in association with physical disability, fatigue, and depression.
  
  
  METHODS
  In a cross-sectional study, 281 (63.4% women, 36.6% men) patients with MS participated in the study. The HRQoL was assessed by the Persian version of the multiple sclerosis quality of life (MSQoL-54) questionnaires. Other covariates included in the study were disease type, physical disability, fatigue, disease impact, and depression.
  
  
  RESULTS
  In univariate analysis disease type, physical disability, fatigue, disease impact, and depression were significantly associated with both physical and mental health composite summaries of MSQoL-54. In multivariate regression analysis, patients' physical disability remained significantly associated with both components of MSQoL-54, whilst fatigue and depression were associated with physical and mental composite summaries, respectively.
  
  
  CONCLUSIONS
  Our findings suggest that MS-related physical disability, fatigue, and depression affect the HRQoL of MS patients, independently of each other and other potential confounding factors. Effective interventions that target fatigue and depression may help improve the QoL of patients, regardless of their disease type and level of disability.
authors.affiliation: Faculty of Physical Education and Sport Sciences, University of Isfahan, Isfahan, Iran. m.hayatbakhsh@uq.edu.au
authors.forename: M
authors.initials: M
authors.lastname: Kargarfard
authors.forename: M
authors.initials: M
authors.lastname: Eetemadifar
authors.forename: M
authors.initials: M
authors.lastname: Mehrabi
authors.forename: A H
authors.initials: AH
authors.lastname: Maghzi
authors.forename: M R
authors.initials: MR
authors.lastname: Hayatbakhsh
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology*; D011788:Quality of Life