Depression mediates the relationship between fatigue and mental health-related quality of life in multiple sclerosis

Fidao, Alexander; Livera, Alysha M De; Nag, Nupur; Neate, Sandra L; Jelinek, George A; Simpson‐Yap, Steve

doi:10.1016/j.msard.2020.102620

Cited by 18 publications

(10 citation statements)

References 45 publications

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“…A study by Fidao et al. showed that the prevalence ratio fatigue among pwMS was significantly lower for patients engaged with high physical activity in comparison to those inactive and minimally active patients, which is not consistent with our findings ( 18 ). Marck et al.…”

Section: Discussioncontrasting

confidence: 99%

“…Fidao et al. showed that the fatigue prevalence ratio was higher among pwMS with high depression risk, severe disability, obesity, smokers, and unemployed but was lower among pwMS with university education and higher IPAQ ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

“…Associations between depression and disability and non-motor symptoms such as fatigue have been studied but the results are inconsistent ( 12 – 15 ). For example, some studies reported a direct association ( 12 , 14 , 16 – 18 ) while others did not ( 19 , 20 ). Furthermore, anxiety was found to be associated with chronic pain while it was moderately associated with disability and fatigue ( 11 , 12 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

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Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients

et al. 2022

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BackgroundMultiple sclerosis (MS) is an inflammatory disease associated with adverse effects: including depression, anxiety, fatigue, which may affect physical activity and the quality of life (QoL) among patients with MS (pwMS).ObjectiveThis study aims to assess the prevalence of depression, anxiety, and fatigue among pwMS who have no physical disability in Saudi Arabia, and demonstrate any correlation between these factors and physical activity as well as the QoL.MethodsA cross-sectional study was conducted in the Neuroimmunology outpatient clinics in King Fahad Medical City (KFMC) and King Saud University Medical City (KSUMC) in Riyadh City, KSA. The Arabic version of the Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression levels. The HADS scores were then categorized into three levels according to the total points: normal (0–7 points), borderline (7–10 points), and anxiety/depression (11 – 21 points). The Arabic version of the Fatigue Severity Scale (FSS) was used to measure fatigue (cut-off point ≥5). The physical activity was measured by the Arabic version of the short form of the International Physical Activity Questionnaire (IPAQ), which measure time spent walking, moderate- and vigorous-intensity physical activity of at least 10 minutes duration. The QoL was also measured by the Arabic version of the EuroQOL five-dimensional (EQ-5D-3L) instrument (i.e., mobility, self-care, usual activities, pain/discomfort, and anxiety/depression).ResultsA total of 323 pwMS participated in this study, 83 had scores that indicated anxiety (25.7%) and 44 had depression (13.6%). The majority of patients had scores with the normal range of depression and anxiety (70% and 57% respectively). The mean of EuroQol Group visual analogue scale (EQ-VAS) score was 80.43 (SD=19.8). 156 (48.3%) out of 323 pwMS reported fatigue while the remainder had no fatigue (n=167, 51.7%). The results indicate that only 143 patients (44.3%) had participated in vigorous physical activity during the last 70 days, with a median of 3 days per week (IQR= 5–3) and a median of 60 minutes per day 0 (Interquartile range: IQR = 60–30). Only 149 patients (49.2%) had patricpated in moderate physical activities during the previous week with a median of 3 days per week (IQR = 5–3) and a median of 40 minutes per day (IQR = 60–30). 194 patients had participated in walking activities (60.0%) with a median of 5 days per week (IQR = 7–3) and a median of 45 minutes per day (IQR = 60–30). The results revealed that fatigue was positively correlated with depression (r = 0.407, p-value < 0.001) and anxiety (r = 0.289, p-value < 0.001).ConclusionThe current study shows depression, anxiety, and fatigue tend to be correlated and clustered together among pwMS in our cohort. However, fatigue is not associated with the intensity of physical activity undertaken. The results of this study are important for the improvement of the clinical management of MS patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients

et al. 2022

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“…However, mental fatigue makes individuals' executive functions impaired, leading to an inability to continuously focus on situational needs and thus to match and adopt optimal strategies, resulting in significantly reduced psychological flexibility (Jacquet et al, 2021). In addition, psychological inflexibility significantly affects negative emotions such as anxiety and depression, leading to a range of psychological problems such as emotional distress, posttraumatic stress disorder (PTSD), and burnout (Fidao et al, 2021). A Spanish study during the COVID-19 pandemic showed that psychological inflexibility predicted changes in mental health (Hernández-López et al, 2021).…”

Section: The Mediating Role Of Psychological Inflexibilitymentioning

confidence: 99%

Mental fatigue and negative emotion among nurses during the COVID-19 pandemic

et al. 2022

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COVID-19 is a major public health event affecting the people worldwide. Nurses are still under immense psychological pressure. This study aimed to explore the relationship between mental fatigue and negative emotions among frontline medical staff during the COVID-19 pandemic. The study was conducted in August 2020, which included 419 medical staff between 17 to 28 years. The Fatigue Scale, Multidimensional Mental Flexibility Questionnaire, Cognitive Fusion Scale, and Depression-Anxiety-Stress Brief Version Scale were used. During the data collection period, the pandemic was under control in China and continued worldwide. The results indicated that 27.7% of the medical staff experienced depression, and 32.3% of them feel stressed. Specifically, first, correlation analyses showed significant positive pairwise correlations between mental fatigue, psychological inflexibility, cognitive fusion, and negative emotions among nurses. Second, mediation model tests showed statistically significant mediating effects of psychological inflexibility and cognitive fusion between mental fatigue on nurses' negative emotions, and statistically, significant chain mediating effects of psychological inflexibility and cognitive fusion. Mental fatigue indirectly affects nurses' negative effects through the mediating effects of psychological inflexibility, cognitive fusion, and the chain mediating effects of psychological inflexibility and cognitive fusion, respectively. the negative effects of mental fatigue come from impairment of cognitive functioning, and interventions using acceptance and commitment therapy for mental fatigue and negative emotions are more effective since both psychological inflexibility and cognitive fusion are important components of the therapy.

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“…The pathology of MS typically involves lesions in several regions of the central nervous system (CNS), including the brain and spinal cord (Haider et al, 2016). The manifestation of MS is variable and negatively impacts physical and mental health (Fidao, et al, 2021). Depression affects more than 22% of veterans with MS (Bambara et al, 2011) and is one of the major causes of disease burden, accounting for the fifth highest global years lived with disability (Walton et al, 2020).…”

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confidence: 99%

Depression and Inflammatory Markers in Veterans With Multiple Sclerosis

Newland

Basan

Chen

et al. 2021

Biological Research For Nursing

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Multiple sclerosis (MS), an inflammatory neurodegenerative disease of the central nervous system (CNS), afflicts over one per thousand people in the United States. The pathology of MS typically involves lesions in several regions, including the brain and spinal cord. The manifestation of MS is variable and carries great potential to negatively impact quality of life (QOL). Evidence that inflammatory markers are related to depression in MS is accumulating. However, there are barriers in precisely identifying the biological mechanisms underlying depression and inflammation. Analysis of cytokines provides one promising approach for understanding the mechanisms that may contribute to MS symptoms. Methods: In this pilot study, we measured salivary levels of interleukin (IL)-6, IL-1beta (β), and IL-10 in 24 veterans with MS. Descriptive statistics were reported and Pearson correlation coefficients were obtained between cytokines and depression. Results: The anti-inflammatory cytokine IL-10 was significantly negatively associated with depression in veterans with MS (r = −0.47, p = .024). Conclusion: Cytokines may be useful for elucidating biological mechanisms associated with the depression and a measure for nurses caring for veterans with MS.

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Depression mediates the relationship between fatigue and mental health-related quality of life in multiple sclerosis

Cited by 18 publications

References 45 publications

Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients

Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients

Mental fatigue and negative emotion among nurses during the COVID-19 pandemic

Depression and Inflammatory Markers in Veterans With Multiple Sclerosis

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