title: Fatigue in a population-based cohort of patients with inflammatory bowel disease 20 years after diagnosis: The IBSEN study.
abstract: OBJECTIVE
  Fatigue is a major concern for patients with ulcerative colitis (UC) and Crohn's disease (CD), but evidence from population-based studies regarding fatigue in long-standing inflammatory bowel disease (IBD) patients is scarce. Our aims were to assess fatigue scores and the prevalence of chronic fatigue in IBD patients 20 years after diagnosis and to identify variables associated with fatigue in this cohort.
  
  
  METHODS
  Twenty years after diagnosis, patients from a cohort with incident IBD were invited to a follow-up visit that included a structured interview, a clinical examination, laboratory tests and the Fatigue Questionnaire (FQ). Fatigue scores were obtained, and factors associated with fatigue were assessed via linear and logistic regression analyses.
  
  
  RESULTS
  Of the 599 invited patients, 440 (73.5%) completed the FQ. Among those with active disease, we found significantly higher fatigue scores than among those with quiescent disease (fatigue scores: UC 17.1 versus 12.4, p < .001, and CD 17.5 versus 13.3, p < .001). The fatigue scores of those with quiescent disease were comparable with those of the reference population. Chronic fatigue was more frequent among IBD patients than in the reference population. Factors associated with fatigue included self-perceived disease activity, poor sleep quality, anxiety and depression.
  
  
  CONCLUSIONS
  At 20 years after IBD diagnosis, fatigue scores were higher and chronic fatigue was more frequent among IBD patients with active disease than in the reference population and among those with quiescent IBD. Subjectively perceived disease activity, sleep quality, anxiety and depression were associated with fatigue in IBD patients.
authors.affiliation: a Department of Gastroenterology , Telemark Hospital , Skien , Norway.
authors.forename: Gert
authors.initials: G
authors.lastname: Huppertz-Hauss
authors.affiliation: b Department of Gastroenterology , Oslo University Hospital Ullevål , Oslo , Norway.
authors.forename: Marte Lie
authors.initials: ML
authors.lastname: Høivik
authors.affiliation: c Department of Gastroenterology, Østfold Hospital Trust , Østfold University College, Fredriksstad , Grålum , Norway.
authors.forename: Lars-Petter
authors.initials: LP
authors.lastname: Jelsness-Jørgensen
authors.affiliation: d Department of Gastroenterology , Oslo University Hospital Ullevål, and Institute of Health and Society, Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Randi
authors.initials: R
authors.lastname: Opheim
authors.affiliation: e Department of Gastroenterology , Østfold Hospital Trust , Grålum , Norway.
authors.forename: Magne
authors.initials: M
authors.lastname: Henriksen
authors.affiliation: f Department of Gastroenterology , Sørlandet Hospital , Arendal , Norway.
authors.forename: Ole
authors.initials: O
authors.lastname: Høie
authors.affiliation: g Department of Gastroenterology , Innlandet Hospital Trust , Brumunddal , Norway.
authors.forename: Øistein
authors.initials: Ø
authors.lastname: Hovde
authors.affiliation: h Department of Gastroenterology , Oslo University Hospital Ullevål , Oslo , Norway.
authors.forename: Iril
authors.initials: I
authors.lastname: Kempski-Monstad
authors.affiliation: h Department of Gastroenterology , Oslo University Hospital Ullevål , Oslo , Norway.
authors.forename: Inger Camilla
authors.initials: IC
authors.lastname: Solberg
authors.affiliation: i Department of Gastroenterology , Akershus University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Jahnsen
authors.affiliation: j Department of Research and Development , Telemark Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Hoff
authors.affiliation: k Department of Gastroenterology , Oslo University Hospital Ullevål, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Moum
authors.affiliation: l Department of Research and Development , Vestfold Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Tomm
authors.initials: T
authors.lastname: Bernklev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000145:classification / Q000150:complications*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Crohn’s disease; fatigue; inflammatory bowel disease; ulcerative colitis