Medline: 10699536

Journal of Pain and Symptom Management 19(2): 91-99, 2000.

Fatigue and psychiatric morbidity among Hodgkin's disease survivors.

Loge JH, Abrahamsen AF, Ekeberg, et al.

Abstract:

Fatigue is prevalent among cancer patients, including Hodgkin's disease survivors (HDS). Fatigue is poorly understood, and the clinical management is consequently difficult. This cross-sectional study examined how fatigue related to psychiatric morbidity among 457 HDS (aged 19-74 years, 56% males) treated during the period 1971-1991. The subjects were mailed a questionnaire including the Fatigue Questionnaire, the Hospital Anxiety and Depression Scale, and measures of previous psychiatric problems. Fatigue correlated moderately with anxiety and depression (r = 0.44 and 0.41 respectively). Twenty-six percent of the HDS had substantial fatigue for 6 months or longer (=cases). They had higher levels of anxiety (mean 7.3, 95% CI 6.4-8.1) and depression (mean 4.5, 95% CI 3.8-5.2) than the non-cases (anxiety: mean 4.3, 95% CI 3.9-4.7; depression: mean 2.1, 95% CI 1.8-2.5). Past psychiatric problems were not reported more commonly among the fatigue cases than among the non-cases. A multiple logistic regression analysis identified age (OR 1.04, 95% CI 1.02-1.06), anxiety (OR 1.2, 95% CI 1.2-1.3), and no self-reported psychiatric symptoms during treatment (OR 2.3, 95% CI 1.3-4.2) as predictors of fatigue caseness. One-half of the fatigue cases among HDS have psychological distress that might respond to treatment. Chronic fatigue among HDS is not predicted by previous psychiatric problems.


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