title: College students with depressive symptoms with and without fatigue: Differences in functioning, suicidality, anxiety, and depressive severity.
abstract: BACKGROUND
  We examined whether fatigue was associated with greater symptomatic burden and functional impairment in college students with depressive symptoms.
  
  
  METHODS
  Using data from the self-report Beck Depression Inventory (BDI), we stratified a group of 287 students endorsing significant symptoms of depression (BDI score ≥ 13) into 3 levels: no fatigue, mild fatigue, or moderate/severe fatigue. We then compared the 3 levels of fatigue across a battery of psychiatric and functional outcome measures.
  
  
  RESULTS
  Approximately 87% of students endorsed at least mild fatigue. Students with moderate/severe fatigue had significantly greater depressive symptom severity compared with those with mild or no fatigue and scored higher on a suicide risk measure than those with mild fatigue. Students with severe fatigue evidenced greater frequency and intensity of anxiety than those with mild or no fatigue. Reported cognitive and functional impairment increased significantly as fatigue worsened.
  
  
  CONCLUSIONS
  Depressed college students with symptoms of fatigue demonstrated functional impairment and symptomatic burden that worsened with increasing levels of fatigue. Assessing and treating symptoms of fatigue appears warranted within this population.
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA. E-mail: mnyer@partners.org.
authors.forename: Maren
authors.initials: M
authors.lastname: Nyer
authors.forename: David
authors.initials: D
authors.lastname: Mischoulon
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Alpert
authors.forename: Daphne J
authors.initials: DJ
authors.lastname: Holt
authors.forename: Charlotte D
authors.initials: CD
authors.lastname: Brill
authors.forename: Albert
authors.initials: A
authors.lastname: Yeung
authors.forename: Paola
authors.initials: P
authors.lastname: Pedrelli
authors.forename: Lee
authors.initials: L
authors.lastname: Baer
authors.forename: Christina
authors.initials: C
authors.lastname: Dording
authors.forename: Ilana
authors.initials: I
authors.lastname: Huz
authors.forename: Lauren
authors.initials: L
authors.lastname: Fisher
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.forename: Amy
authors.initials: A
authors.lastname: Farabaugh
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology*; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D012720:Severity of Illness Index; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D013405:Suicide / Q000706:statistics & numerical data; D014495:Universities; D055815:Young Adult