Development of a clinician-administered National Institutes of Health-Brief Fatigue Inventory: A measure of fatigue in the context of depressive disorders

Abstract

Objective Fatigue is a complex, multidimensional condition. Although it is often associated with depression, it is not known whether it has a distinct network from depression or whether it can be clinically evaluated, separately. This study describes preliminary findings in the development of a brief, clinician-administered instrument to measure fatigue in the context of depressive disorders using items from existing clinician-administered depression and mania scales. Methods Based on items from prior fatigue measurements, items were selected from the Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale, and Structured Interview Guide for HDRS with Atypical Depression. The final items composed the NIH-Brief Fatigue Inventory (NIH-BFI). Responses from 89 depressed adults collected pre- and post-antidepressant therapy (ADT) determined the reliability and consistency of the NIH-BFI using Cronbach’s alpha and principal components analysis (PCA). Correlations of the NIH-BFI and fatigue items from other scales before and after ADT explored validity. Results The 7-item NIH-BFI had Cronbach alphas ranging from 0.81–0.88 and PCA indicating a single dimension. The NIH-BFI score was strongly correlated (r=0.73, p<0.001) with fatigue items from Beck Depression Index, with MADRS without fatigue items (r=0.77, p<0.001), and HDRS without fatigue items (pre: r=0.69, p<0.001). Conclusions Preliminary findings show support for internal consistency reliability and validity of the NIH-BFI, a clinician-administered measure of fatigue. Further testing in other clinical populations is recommended to obtain additional information on reliability and validity. The NIH-BFI provides a method for clinician-rated fatigue that may be a separate from depression.

An assessment of the anti-fatigue effects of ketamine from a double-blind, placebo-controlled, crossover study in bipolar disorder

“…Fatigue was assessed using the 7-item, clinician-administered NIH-Brief Fatigue Inventory (NIH-BFI) (Saligan et al, 2015). The NIH-BFI was developed from items of existing clinician-administered psychiatric scales administered in the NIMH clinical trial (i.e., Hamilton Depression Rating Scale (17 Item) [HDRS], Montgomery-Asberg Depression Rating Scale [MADRS], Young Mania Rating Scale [YMRS], and Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression [SIGH-SAD]).…”

A systematic review of the association between fatigue and cognition in chronic noncommunicable diseases

“…Fatigue is a symptom that often accompanies NCDs. 22 Because it is a subjective state that has both physical and psychological elements, 17 fatigue is often characterized by the context in which it is experienced. More specifically, fatigue may occur as a result of a physical or psychological event, or fatigue may be the cause of a physical or psychological event.…”

“…Fatigue is defined as a subjective symptom marked by a generalized sense of depleted energy, feelings of tiredness, or lack of energy that leads to a decreased capacity for physical or mental performance. 15–17 Although healthy people may experience fatigue, it is one of the most common complaints among individuals suffering from chronic illness. 16,18 In healthy persons, fatigue occurs as a normal and temporary phenomenon, whereas illness-related fatigue may persist despite adequate amounts of rest and sleep.…”

Disentangling the association of depression on the anti-fatigue effects of ketamine

“…For this purpose, we have incorporated independent measures of fatigue and depression in our clinical trials. We developed the National Institutes of Health-Brief Fatigue Inventory (NIH-BFI) as a distinct measure of fatigue within the context of depression (Saligan, et al, 2015), and administered the Montgomery-Asberg Depression Rating Scale (MADRS), a commonly used unidimensional measure of depressive symptoms (Montgomery & Asberg, 1979). Our published reports on the anti-depressant and anti-fatigue effects of ketamine provide the unique possibility of advancing our understanding on how fatigue and depression are closely related (Zarate et al, 2006;Saligan et al, 2016).…”