Fatigue and depression in children with multiple sclerosis and monophasic variants

Ketelslegers, Immy A.; Catsman‐Berrevoets, Coriene E.; Boon, Maartje; Eikelenboom, Merijn; Stroink, Hans; Neuteboom, Rinze F.; Aarsen, Femke K.; Putte, Elise M. van de; Hintzen, Rogier Q.

doi:10.1016/j.ejpn.2009.09.004

Cited by 41 publications

(62 citation statements)

References 22 publications

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Section: Summary Of Evidencementioning

confidence: 99%

“…46,47 Moderate to strong associations were consistently reported between fatigue and depression, with greater fatigue associated with higher ratings of depressed mood (r values ranged from 0.34 to 0.49; r s =0.48-0.84). 6,20,35,37,46 In one study in which parent-and self-reported fatigue were independently measured, greater parent-and self-reported general and cognitive fatigue, but not sleep/rest fatigue, were moderately associated with higher scores on the Childhood Depression Inventory. 6 Another study reported moderate positive correlations between self-reported general and cognitive fatigue, but not sleep/rest fatigue, and parent-reported depression in a mixed multiple sclerosis and acute disseminated encephalomyelitis sample.…”

Section: Fatigue and Psychiatric Disordersmentioning

confidence: 99%

Section: Summary Of Evidencementioning

confidence: 99%

“…Positive correlations between fatigue and depressed mood were consistently reported. 6,20,35,37,46 Investigations into the relationship between fatigue and neurocognitive functioning suggested that fatigue is unrelated to overall neurocognitive functioning.6,40-42 However, there was some evidence to suggest that fatigued caMS have impaired performance on some individual cognitive tasks, particularly motor-based tasks such as the Trail Making Test A and B, and on tasks requiring prolonged and complex mental activity, such as problem solving, complex attention and processing speed, and language comprehension tasks.6,33 At present, the evidence does not substantially support a relationship between fatigue and any specific domain of cognitive functioning. Rather, it appears that fatigued patients may exhibit worse performance on prolonged tasks of executive functioning that may be particularly tiresome or effortful.…”

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Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Carroll

Chalder

Hemingway

et al. 2015

Develop Med Child Neuro

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AIM Fatigue in children and adolescents with multiple sclerosis (caMS) is currently poorly understood. This review aimed to provide greater insight into this area and direction for future research by evaluating evidence of associations between fatigue and clinical, psychological, and social factors in caMS.METHOD Studies were identified by searching online databases, hand-searching reference lists, and requesting unpublished literature from key authors. Studies that examined fatigue in relation to at least one clinical, psychological, or social factor in caMS were included. Data on design, sample characteristics, measures of fatigue, clinical, psychological, and social variables, and key findings were extracted. Twelve studies were narratively synthesized.RESULTS Clinical factors appeared largely unrelated to fatigue, whereas associations between fatigue and tests of neurocognitive functioning, and fatigue and diagnosable psychiatric disorders, were mixed. However, fatigue and depressed mood consistently correlated. A small number of studies indicated associations between fatigue and reduced quality of life and school performance.INTERPRETATION A sufficient explanatory model of fatigue in caMS is lacking as studies in this area are few and diverse. Future research should endeavour to identify potentially modifiable clinical and psychosocial factors that are associated with fatigue in caMS so that interventions targeting such factors may be developed.Multiple sclerosis is a chronic neurodegenerative disorder characterized by inflammation and demyelination in the central nervous system, most often diagnosed in adulthood. 1 In rare cases, multiple sclerosis is diagnosed in childhood or adolescence.2 Paediatric acquired demyelinating syndromes, including paediatric multiple sclerosis, have an incidence rate of approximately 1 in 100 000. 3 In adult multiple sclerosis, sensory and motor impairments, optic neuritis, and bladder and bowel dysfunction are among the most common physical symptoms. In paediatrics, physical symptoms are less predominant but cognitive deficits more troublesome, typically affecting attention and processing speed, language, memory, and visuomotor functioning. [4][5][6] Moreover, psychosocial factors such as depression, lower quality of life, and fatigue are concerning features of paediatric multiple sclerosis, yet these features have received limited research attention to date. 6,7 Fatigue is the most common and one of the most disabling symptoms of multiple sclerosis, experienced by around 80% of adults with the disease. [8][9][10] Multiple sclerosis-related fatigue refers to a severe and overwhelming feeling of exhaustion and lack of energy, which may result in functional impairment.11 A growing body of evidence suggests that fatigue is also a significant problem in paediatric populations, affecting approximately 30% of the general adolescent population and a substantial proportion of children and adolescents with chronic illnesses such as cancer, rheumatoid arthritis, chronic pain, and neur...

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Section: Summary Of Evidencementioning

confidence: 99%

Section: Fatigue and Psychiatric Disordersmentioning

confidence: 99%

Section: Summary Of Evidencementioning

confidence: 99%

mentioning

confidence: 99%

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Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Carroll

Chalder

Hemingway

et al. 2015

Develop Med Child Neuro

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“…MSPatienten haben ein höheres Risiko, eine Depression zu entwickeln, als andere neurologisch kranke Patienten [20]. So wird das Vorliegen einer Depression bei Kindern und Jugendlichen mit MS mit einer Häufigkeit von 6-46% angegeben [15,21,22,23] …”

Section: Kognition Depression Und Fatigueunclassified

Besonderheiten der multiplen Sklerose im Kindes- und Jugendalter

Gravesande

2015

Paediatr. Paedolog. Austria

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Die multiple Sklerose (MS) im Kindesund Jugendalter ist wie bei den Erwachsenen eine chronisch-entzünd-liche und demyelinisierende Erkrankung des zentralen Nervensystems (ZNS). Neben vielen Gemeinsamkeiten mit der MS im Erwachsenenalter gibt es auch einige Besonderheiten, die den klinischen Verlauf beeinflussen und in derBehandlung und Betreuung der jungen Patienten berücksichtigt werden sollten. Insbesondere das Auftreten von neurokognitiven Defiziten, Depression und Fatigue stellen in diesem Alter eine Herausforderung dar.

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Prevalence of Severe Fatigue Among Adolescents With Pediatric Rheumatic Diseases

Nijhof

Putte

Wulffraat

et al. 2015

Arthritis Care & Research

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Objective To determine the prevalence of severe fatigue and fatigue‐related limitations among adolescents with juvenile idiopathic arthritis (JIA) and other pediatric rheumatic diseases (PRDs). In addition, we assessed the effect of disease activity and pain on the severity of fatigue. Methods This cross‐sectional study included 175 patients (ages 10–18 years) who visited the pediatric rheumatology and immunology outpatient clinic at Wilhelmina Children's Hospital from April through July 2013. Patients completed validated questionnaires regarding fatigue, physical functioning, and school attendance. Disease activity in JIA patients was measured using the Juvenile Arthritis Disease Activity Score including 27 joints. The results were compared against a healthy control group. Results The prevalence of severe fatigue among patients with PRDs was 25.1%, which was significantly higher than among the healthy control group (P < 0.001). Fatigued patients had significantly lower levels of physical functioning compared to nonfatigued patients (62.1% versus 89.0%, respectively; P < 0.001) and a significantly higher percentage of school absences (21.2% versus 11.6%, respectively; P = 0.005). Among JIA patients, the level of pain was significantly correlated with fatigue. Finally, disease activity was not a predictor for fatigue. Conclusion Fatigue is a common problem among teenagers with PRDs, with a higher prevalence among these patients than in the general population. Severe fatigue leads to significant impairments, including increased school absences and decreased physical functioning. Interestingly, fatigue was associated with pain, but not with the disease activity. Therefore, in this patient population, fatigue may be a promising therapeutic target for improving functioning, school attendance, and possibly pain as well.

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Fatigue and depression in children with multiple sclerosis and monophasic variants

Cited by 41 publications

References 22 publications

Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Besonderheiten der multiplen Sklerose im Kindes- und Jugendalter

Prevalence of Severe Fatigue Among Adolescents With Pediatric Rheumatic Diseases

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