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

Authors

1 Department of Exercise physiology, Faculty of Humanities, lslamic Azad University Sari

2 Department of Exercise physiology, Faculty of Humanities, lslamic Azad University Ghaem Shahr. Branch, Ghaem Shar, Iran

Abstract

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.

Keywords

References

1-Rader JI, Peeler JT, Mahaffey KR.Comparative toxicity and tissue distribution of lead acetate in weanling and adult rats. Environment  Health Perspect 1981; 42: 187–195.
 2- Mudipalli A. Lead hepatotoxicity & potential health effects. Indian J Med Res. 2007;126:518-27.
 3-Lyn Patrick  ND. Lead Toxicity Part II: The Role of Free Radical Damage and the Use of Antioxidants in the Pathology and Treatment of Lead Toxicity. Alternative Medecine Review.2006; 11:114-127.
 4- DeMichele SJ. Nutrition of  lead. Comp Biochem Physiol Part A  1984;78:401-408.
 5- Milosevic N, Maier P. Lead stimulates intercellular signaling between hepatocytes and Kupffer cells. Eur J Pharmacol 2000;401:317-328.
 6- Allouche  L, Hamadouche M, Touabti A Khennouf S. Effect of Long-term Exposure to Low or Moderate Lead Concentrations on Growth, Lipid Profile and Liver Function in Albino Rat. Advances in Biological Research 2011;5: 339-347.
 7- Titcomb CP Jr. Liver Function Tests: What is the Risk? J Insur  Med 2003;35:26-35.
 8- Alizadeh Namini M,Fereudouni M, Mahdavi Shari N,Moghimi A.Protective and therapeutic effects of Curcuma longa powder on the CCL4 inducedhepatic damage. Physiol Pharmacol  2005;:143-150.
 9- Todorovic T, Vujanovic D. The influence of magnesium on the activity of some enzymes (AST, ALT, ALP) and lead content in some tissues. Magnes Res 2002;15:173-7.
 10-Belviranlı M, Gokbel H, Okudan N, Buyukbas S. Effects of Grape Seed Polyphenols on Oxidative Damage in Liver Tissue of Acutely and Chronically Exercised Rats. Phytother Res 2012.
 11-Kawanishi N, Yano H, Mizokami T, Takahashi M, Oyanagi E, Suzuki K. Exercise training attenuates hepatic inflammation, fibrosis and macrophage infiltration during diet induced-obesity in mice. Brain Behav Immun  2012;26:931-41.
 12- Memarmoghaddam M, Dabidy Roshan V, Hedayati M. Effects of Lead Acetate, Endurance Training and Curcumin Supplementation on Heat Shock Protein Levels in Liver Tissue. Iranian Journal of Endocrinology and Metabolism 2011;13:74-82.
 13- Davoodi M, Moosavi H, Nikbakht M. The effect of eight weeks selected aerobic exercise on liver parenchyma and liver enzymes (AST, ALT) of fat liver patients. J Shahrekord Univ Med Sci 2012;14:84-90.
 14- Marques CM, Motta VF, Torres TS, Aguila MB, Mandarim-de-Lacerda CA. Beneficial effects of exercise training (treadmill) on insulin resistance and nonalcoholic fatty liver disease in high-fat.  Braz J Med Biol Res  2010 ;43:467-75.
 15- Anand P, Thomas SG, Kunnumakkara AB, Sundaram C, Harikumar KB, Sung B, et al. Biological activities of curcumin and its analogues(Congeners) made by man and Mother Nature. Biochem Pharmacol. 2008 1;76:1590-611.
 16- el-Ashmawy IM, el-Nahas AF, Salama OM. Protective effect of volatile oil, alcoholic and aqueous extracts of Origanum majorana on lead acetate toxicity in mice. Basic Clin Pharmacol Toxicol. 2005;97:238-43.
 17- Daniel S, Limson JL, Dairam A, Watkins GM, Daya S. Through mental binding, curcumin protects against lead- and Cadmium - induced lipid peroxidation in rat brain homogenates and against lead-induced tissue damage in rat brain. J Inorg Biochem 2004; 98(2):266-75.
 18-Ennulat D, Magid-Slav M, Rehm S, Tatsuoka KS.Diagnostic performance of traditional hepatobiliary biomarkers of drug-induced liver injury in the rat. Toxicol Sci. 2010;116(2):397-412.
19- Sipos  P, Szentmihalyi  K,  Feher E, Abaza  M, Szilagyi M, Blazovics A. Some effects of lead contamination on liver and gallbladder bile. Acta Biologica Szegediensis 2003; 47:139-142.
20-Farzanegi P, Saberi S, Fakharian A, Rasaee MJ,Dabidi Roshan V.Combined Effects of Curcuma longa and Exercise Training on Kidney and Spleen Tissue Levels of Glutathione Peroxidase and Protein Carbonyl in Rats Exposed to Lead.MJMS: Pathobiology.2012; 15(3):49-62.
21. Sharma V, Pandey D. Protective Role of Tinospora cordifolia against Lead-induced Hepatotoxicity. Toxicol Int. 2010; 17: 12–17.
22. Vaziri ND. Causal Link Between Oxidative Stress, Inflammation, and Hypertension. IJKD. 2008;2:1-10.
Daneshvar Medicine
Volume 20, Issue 5 - Serial Number 102
January and February 2013
Pages 63-70

Files

Share

How to cite

Statistics