Fatigue in paediatric MS: a systematic review (authors incl. Chalder & Moss-Morris)

[Dolphin]

http://onlinelibrary.wiley.com/doi/...ionid=474B3F62B38807D53182853631B8A5C4.f02t04

Systematic Review

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

Susan Carroll1,
Trudie Chalder2,
Cheryl Hemingway3,
Isobel Heyman4 and
Rona Moss-Morris1,*

Abstract

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Studies were identified by searching online databases, hand-searching reference lists, and requesting unpublished literature from key authors.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.

 

[TiredSam]

Moving on to the next group of patients to abuse already. Sick children, of course.

 

[worldbackwards]

Fatigue in children and adolescents with multiple sclerosis (caMS) is currently poorly understood.

Red rag to a bull there then.

 

[TiredSam]

Red rag to a bull there then.

Red rag to a bully.

 

[A.B.]

Telling sick people that their symptoms are caused by poor attitude is abuse, and not "positive thinking".

 

[Snow Leopard]

Looking at the evidence, yet so blind.

The severity of a symptom as reported on a questionnaire is not the same as the experience of that symptom. The effect they are measuring between psychological factors and symptoms is that psychological factors bias how those symptoms are reported.

 

[Woolie]

This paper reports on a few previous studies, a couple of which found a relationship between self-reported fatigue and self-reported depression in these kids. Some of the scales used in the studies are pediatric ones, so I don't know them off by heart.

But its worth pointing out that most depression scales include a good proportion of items that ask directly about fatigue and other "somatic symptoms". So you're not measuring two independent things, but rather two very messy and partially overlapping constructs. Makes no sense at all!

 

[Woolie]

Telling sick people that their symptoms are caused by poor attitude is abuse, and not "positive thinking".

This is a tweetable quote, @A.B.! Especially if the link to the abstract is added. Anyone twitter-wise want to take up the challenge?