Understanding Predictors of Fatigue Over Time in Persons With Inflammatory Bowel Disease : The Importance of Depressive and Anxiety Symptoms
Copyright © 2024 by The American College of Gastroenterology..
INTRODUCTION: Fatigue is a complex and frequent symptom in persons with inflammatory bowel disease (IBD), with detrimental impact. We aimed to determine predictors of fatigue over time.
METHODS: Two hundred forty-seven adults with IBD participated in a prospective study conducted in Manitoba, Canada, providing data at baseline and annually for 3 years. Participants reported fatigue impact (Daily Fatigue Impact Scale [DFIS]), depression and anxiety symptoms (Hospital Anxiety and Depression Scale [HADS]), and pain (Pain Effects Scale [PES]). Physician-diagnosed comorbidities, IBD characteristics, and physical and cognitive functioning were also assessed. We tested factors associated with fatigue using multivariable generalized linear models that estimated within-person and between-person effects.
RESULTS: Most participants were women (63.2%), White (85.4%), and had Crohn's disease (62%). At baseline, 27.9% reported moderate-severe fatigue impact, 16.7% had clinically elevated anxiety (HADS-A ≥11), and 6.5% had clinically elevated depression (HADS-D ≥11). Overall fatigue burden was stable over time, although approximately half the participants showed improved or worsening fatigue impact between annual visits during the study. On multivariable analysis, participants with a one-point higher HADS-D score had, on average, a 0.63-point higher DFIS score, whereas participants with a one-point higher PES score had a 0.78-point higher DFIS score. Within individuals, a one-point increase in HADS-D scores was associated with 0.61-point higher DFIS scores, in HADS-A scores with 0.23-point higher DFIS scores, and in PES scores with 0.38-point higher DFIS scores. No other variables predicted fatigue.
DISCUSSION: Anxiety, depression, and pain predicted fatigue impact over time in IBD, suggesting that targeting psychological factors and pain for intervention may lessen fatigue burden.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
The American journal of gastroenterology - (2024) vom: 26. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bernstein, Charles N [VerfasserIn] |
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Date Revised 25.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.14309/ajg.0000000000002630 |
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| Förderinstitution / Projekttitel: |
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NLM365791466 |
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| 100 | 1 | |a Bernstein, Charles N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Understanding Predictors of Fatigue Over Time in Persons With Inflammatory Bowel Disease |b The Importance of Depressive and Anxiety Symptoms |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 by The American College of Gastroenterology. | ||
| 520 | |a INTRODUCTION: Fatigue is a complex and frequent symptom in persons with inflammatory bowel disease (IBD), with detrimental impact. We aimed to determine predictors of fatigue over time | ||
| 520 | |a METHODS: Two hundred forty-seven adults with IBD participated in a prospective study conducted in Manitoba, Canada, providing data at baseline and annually for 3 years. Participants reported fatigue impact (Daily Fatigue Impact Scale [DFIS]), depression and anxiety symptoms (Hospital Anxiety and Depression Scale [HADS]), and pain (Pain Effects Scale [PES]). Physician-diagnosed comorbidities, IBD characteristics, and physical and cognitive functioning were also assessed. We tested factors associated with fatigue using multivariable generalized linear models that estimated within-person and between-person effects | ||
| 520 | |a RESULTS: Most participants were women (63.2%), White (85.4%), and had Crohn's disease (62%). At baseline, 27.9% reported moderate-severe fatigue impact, 16.7% had clinically elevated anxiety (HADS-A ≥11), and 6.5% had clinically elevated depression (HADS-D ≥11). Overall fatigue burden was stable over time, although approximately half the participants showed improved or worsening fatigue impact between annual visits during the study. On multivariable analysis, participants with a one-point higher HADS-D score had, on average, a 0.63-point higher DFIS score, whereas participants with a one-point higher PES score had a 0.78-point higher DFIS score. Within individuals, a one-point increase in HADS-D scores was associated with 0.61-point higher DFIS scores, in HADS-A scores with 0.23-point higher DFIS scores, and in PES scores with 0.38-point higher DFIS scores. No other variables predicted fatigue | ||
| 520 | |a DISCUSSION: Anxiety, depression, and pain predicted fatigue impact over time in IBD, suggesting that targeting psychological factors and pain for intervention may lessen fatigue burden | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Fisk, John D |e verfasserin |4 aut | |
| 700 | 1 | |a Dolovich, Casandra |e verfasserin |4 aut | |
| 700 | 1 | |a Hitchon, Carol A |e verfasserin |4 aut | |
| 700 | 1 | |a Graff, Lesley A |e verfasserin |4 aut | |
| 700 | 1 | |a El-Gabalawy, Renée |e verfasserin |4 aut | |
| 700 | 1 | |a Lix, Lisa M |e verfasserin |4 aut | |
| 700 | 1 | |a Bolton, James M |e verfasserin |4 aut | |
| 700 | 1 | |a Patten, Scott B |e verfasserin |4 aut | |
| 700 | 1 | |a Marrie, Ruth Ann |e verfasserin |4 aut | |
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