The effect of fatigue and clinical course on depression, anxiety, stress, quality of life and employment status in patients with multiple sclerosis

 Background and Objective: Fatigue is a common
symptom in multiple sclerosis (MS) and
most MS patients are of two types relapsing-remitting (RRMS) and secondary progressive (SPMS). Fatigue with regard to feeling of weakness,
lack of energy and clinical
course due to the establishment of a
variable prognosis can influence psychological symptoms, functional ability and
employment status of patients. Thus, the aim of the present study was to evaluate the effect of fatigue and
clinical course on psychological
symptoms, physical and psychological dimensions,
and employment status.
 Materials
and Methods: In this retrospective cross-sectional study, 152 patients were sampled by consecutive method. All patients were
evaluated using fatigue severity scale (FSS), depression, anxiety, and stress scale (DASS-21)
and short form
health survey questionnaire
(SF-36). Data were analyzed using multivariate variance analysis (MANOVA)
and Fisher exact test. Results:
Mean
of psychological symptoms and physical and psychological
dimensions scores in fatigued and SPMS patients
was worse than non-fatigued and RRMS groups. Also, un-employment
was reported with
higher frequency in fatigued patients. In this regard, no significant finding
was observed between RRMS and SPMS. In
addition, the difference between both groups of fatigued
and non-fatigued, RRMS and SPMS patients
was significant regarding the variables
depression, anxiety, stress, and physical
and psychological dimensions (p < 0.05). Conclusion:
This
study explained the impact of fatigue and clinical course on psychological symptoms, physical and psychological
aspects of life and employment status of MS
patients. However, it seems that the influence of some variables on each other in a bidirectional
relationship is also explainable. Clinical implications have been discussed
in this report.