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Neurovegetative Symptoms in Patients with Multiple Sclerosis: Fatigue, not Depression

Published online by Cambridge University Press:  10 November 2010

Amanda R. Rabinowitz ,
Aaron J. Fisher  and
Peter A. Arnett
Amanda R. Rabinowitz*
Affiliation:
Psychology Department, The Pennsylvania State University, University Park, Pennsylvania
Aaron J. Fisher
Affiliation:
Psychology Department, The Pennsylvania State University, University Park, Pennsylvania
Peter A. Arnett
Affiliation:
Psychology Department, The Pennsylvania State University, University Park, Pennsylvania
*
Correspondence and reprint requests to: Amanda R. Rabinowitz, Department of Psychology, The Pennsylvania State University, 420 Moore Building, University Park, PA 16802-3106. E-mail: arr200@psu.edu
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Abstract

Elucidating the relationship between fatigue and depression in multiple sclerosis (MS) patients is complicated by ambiguity regarding how these two constructs should be delineated. Neurovegetative symptoms of depression may reflect depression in MS patients, as they do in non-neurological populations; instead these items may measure disease-related fatigue; or disease-related fatigue and depression may reflect the same syndrome in MS patients. The present study sought to evaluate these possibilities by characterizing the underlying factor structure of self-report items designed to measure fatigue and depression symptoms. Questionnaires designed to measure fatigue and depression were administered to 174 MS patients and 84 healthy controls, and these items were subject to factor analysis. Results suggest that neurovegetative symptoms are poor indicators of depression in MS patients. Neurovegetative depression items were removed from the final model due to poor psychometric properties, or they loaded on Fatigue or Sleep Disturbance factors. The correlation between latent factors Depression and Fatigue was large (.47), but does not indicate that these phenomena are manifestations of the same construct. Hence, the results of this study support the notion that vegetative symptoms of depression do not reflect depression in MS patients, but instead measure symptoms of fatigue and sleep disturbance. (JINS, 2010, 17, 000–000)

Keywords

Demyelinating diseasesNeurodegenerative diseasesDiagnosisSymptomsMood disordersFactor analysis
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 1 , January 2011 , pp. 46 - 55
Copyright
Copyright © The International Neuropsychological Society 2010

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References

Aikens, J.E., Reinecke, M.A., Pliskin, N.H., Fischer, J.S., Wiebe, J.S., McCracken, L.M., et al. (1999). Assessing depressive symptoms in multiple sclerosis: Is it necessary to omit items from the original Beck Depression Inventory? Behavioral Medicine, 22, 127–142.Google Scholar
Amato, M.P., Ponziani, G., Rossi, F., Liedl, C.L., Stefanile, C., Rossi, L. (2001). Quality of life in multiple sclerosis: The impact of depression, fatigue, and disability. Multiple Sclerosis, 7, 340–344.Google Scholar
Arnett, P.A., Barwick, F.H., Beeney, J.E. (2008). Depression in multiple sclerosis: Review and theoretical proposal. Journal of the International Neuropsychological Society, 14, 691–724.Google Scholar
Beck, A.T. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist, 46, 368–375.CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A. (1987). BDI: Beck depression inventory manual. New York: Psychological Corporation.Google Scholar
Beck, A.T., Steer, R.A., Carbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.Google Scholar
Beeney, J., Arnett, P.A. (2008). Endorsement of self-report neurovegetative items of depression is associated with multiple sclerosis disease symptoms. Journal of the International Neuropsychological Society, 14, 1057–1062.CrossRefGoogle ScholarPubMed
Cattell, R.B. (1978). The scientific use of factor analysis in behavioral and life sciences. New York: Plenum Press.Google Scholar
Fisk, J.D., Pontefract, A., Ritvo, P.G., Archibald, C.J., Murray, T.J. (1994). The impact of fatigue on patients with multiple sclerosis. Canadian Journal of Neurological Sciences, 21, 9–14.CrossRefGoogle ScholarPubMed
Flachenecker, P., Kumpfel, T., Kallmann, B., Gottschalk, M., Grauer, O., Rieckmann, P., et al. (2002). Fatigue in multiple sclerosis: A comparison of different rating scales and correlation to clinical parameters. Multiple Sclerosis, 8, 523–526.Google Scholar
Freal, J.E., Kraft, G.H., Coryell, J.K. (1984). Symptomatic fatigue in multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 65, 135.Google Scholar
Gotlib, I.H., Cane, D.B. (1987). Construct accessibility and clinical depression: A longitudinal investigation. Journal of Abnormal Psychology, 96, 199–204.Google Scholar
Guilford, J.P. (1954). Psychometric methods. New York: McGraw-Hill.Google Scholar
Janardhan, V., Bakshi, R. (2002). Quality of life in patients with multiple sclerosis: The impact of fatigue and depression. Journal of the Neurological Sciences, 205, 51–58.CrossRefGoogle ScholarPubMed
Joffe, R.T., Lippert, G.P., Gray, T.A., Sawa, G., Horvath, Z. (1987). Mood disorder and multiple sclerosis. Archives of Neurology, 44, 376–378.Google Scholar
Joreskog, K.G., Sorbom, D. (2006). LISREL 8.8. Chicago: Scientific Software International.Google Scholar
Kaynak, H., Altintas, A., Kaynak, D., Uyanik, O., Saip, S., Agaoglu, J., et al. (2006). Fatigue and sleep disturbance in multiple sclerosis. European Journal of Neurology, 13, 1333–1339.Google Scholar
Krupp, L.B., Alvarez, L.A., LaRocca, N.G., Scheinberg, L.C. (1988). Fatigue in multiple sclerosis. Archives of Neurology, 45, 435–438.Google Scholar
Krupp, L.B., Christodoulou, C. (2001). Fatigue in multiple sclerosis. Current Neurology and Neuroscience Reports, 1, 294–298.Google Scholar
Krupp, L.B., LaRocca, N.G., Muir-Nash, J., Steinberg, A.D. (1989). The Fatigue Severity Scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 1121–1123.Google Scholar
Lee, S.Y., Poon, W.Y., Bentler, P.M. (1992). Structural equation models with continuous and polytomous variables. Psychometrika, 57, 89–105.Google Scholar
MacCallum, R.C., Widaman, K.F., Zhang, S., Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4, 84–99.Google Scholar
McDonald, W.I., Compston, A., Edan, G., Goodkin, D., Hartung, H.-P., Lublin, F.D., et al. (2001). Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis. Annals of Neurology, 50, 121–127.Google Scholar
Mohr, D.C., Goodkin, D.E. (1999). Treatment of depression in multiple sclerosis: Review and meta-analysis. Clinical Psychology: Science and Practice, 6, 1–9.Google Scholar
Mohr, D.C., Hart, S.L., Goldberg, A. (2003). Effects of treatment for depression on fatigue in multiple sclerosis. Psychosomatic Medicine, 65, 542–547.CrossRefGoogle ScholarPubMed
Moller, A., Wiedemann, G., Rohde, U., Backmund, H., Sonntag, A. (1994). Correlates of cognitive impairment and depressive mood disorder in multiple sclerosis. Acta Psychiatrica Scandinavica, 89, 117–121.Google Scholar
Moran, P.J., Mohr, D.C. (2005). The validity of Beck Depression Inventory and Hamilton Rating Scale for Depression items in the assessment of depression among patients with multiple sclerosis. Journal of Behavioral Medicine, 28, 35–41.CrossRefGoogle ScholarPubMed
Multiple Sclerosis Council for Clinical Practice Guidelines. (1998). Fatigue and multiple sclerosis: Evidence-based management strategies for fatigue in multiple sclerosis. Washington, DC: Paralyzed Veterans of America.Google Scholar
Nyenhuis, D.L., Luchetta, T., Yamamoto, C., Terrien, A., Bernardin, L., Rao, S.M., et al. (1998). The development, standardization, and initial validation of the Chicago Multiscale Depression Inventory. Journal of Personality Assessment, 70, 386–401.Google Scholar
Nyenhuis, D.L., Rao, S.M., Zajecka, J., Luchetta, T., Bernardin, L., Garron, D.C. (1995). Mood disturbance versus other symptoms of depression in multiple sclerosis. Journal of the International Neuropsychological Society, 1, 291–296.Google Scholar
Patten, S.B., Beck, C.A., Williams, J.V.A., Barbui, C., Metz, L.M. (2003). Major depression in multiple sclerosis: A population-based perspective. Neurology, 61, 1524–1527.Google Scholar
Pepper, C.M., Krupp, L.B., Friedberg, F., Doscher, C., Coyle, P.K. (1993). A comparison of neuropsychiatric characteristics in chronic fatigue syndrome, multiple sclerosis, and major depression. Journal of Neuropsychiatry and Clinical Neuroscience, 5, 200–205.Google Scholar
Poser, C.M., Paty, D.W., Scheinberg, L., McDonald, I.W., Davis, F.A., Ebers, G.C., et al. (1983). New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Annals of Neurology, 13, 227–231.Google Scholar
Rammohan, K.W., Rosenberg, J.H., Lynn, D.J., Blumenfeld, A.M., Pollak, C.P., et al. (2002). Efficacy and safety of modafinil (Provigil (R)) for the treatment of fatigue in multiple sclerosis: A two centre phase 2 study. British Medical Journal, 72, 179.Google Scholar
Schwartz, C.E., Coulthard-Morris, L., Zeng, Q. (1996). Psychosocial correlates of fatigue in multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 77, 165–170.CrossRefGoogle ScholarPubMed
Schwid, S.R., Covington, M., Segal, B.M., Goodman, A.D. (2002). Fatigue in multiple sclerosis: Current understanding and future directions. Journal of Rehabilitation Research and Development, 39, 211–224.Google ScholarPubMed
Strober, L.B., Arnett, P.A. (2005). An examination of four models predicting fatigue in multiple sclerosis. Archives of Clinical Neuropsychology, 20, 631–646.Google Scholar
Voss, W.D., Arnett, P.A., Higginson, C., Randolph, J.J., Campos, M.D., Dyck, D.G. (2002). Contributing factors to depressed mood in multiple sclerosis. Archives of Clinical Neuropsychology, 17, 103–115.Google Scholar