2nd Department of Psychiatry, Attikon General Hospital, Athens University Medical School, 1 Rimini St, 12462 Athens, Greece.
Qual Life Res. 2011 Apr;20(3):457-65. doi: 10.1007/s11136-010-9769-3. Epub 2010 Oct 16.
This study aimed to investigate the psychometric properties of the Fatigue Severity Scale (FSS), a widely used unidimensional fatigue measure, in patients with major depression.
Subjects included were 72 patients with major depressive disorder, diagnosed with the DSM-IV based M.I.N.I. 5.0.0., without comorbid fatigue-associated conditions and Hamilton Depression Rating Scale (HDRS) scores ≥ 17 as well as 40 sex- and age-matched healthy controls. The FSS was administered to patients on two time points separated by a 1-week interval and to controls. The vitality subscale of the 36-item Short Form Health Survey (SF-36vit) and a visual analogue fatigue scale (VASF) were also administered.
A total of 79.2% of patients vs. 15% of controls were fatigue cases according to the M.I.N.I. fatigue/energy loss item. The distribution of FSS scores was negatively skewed in the patient group, demonstrating a ceiling effect. The FSS presented satisfactory test-retest reliability (intraclass correlation coefficient 0.993), internal consistency (Cronbach's α coefficient 0.947), concurrent validity (correlations with SF-36vit, VASF and HDRS were -0.52, 0.73 and 0.32, respectively) and discriminative validity between patients and controls. Factor analysis demonstrated a unidimensional structure. The optimal FSS cutoff score for clinically significant fatigue was 5.4 against the presence of fatigue/energy loss according to the M.I.N.I. as a 'gold standard'.
When administered to patients with major depression, the FSS was shown to have satisfactory psychometric properties with the exception of a ceiling effect, which may pose limitations to its use in this population.
本研究旨在探讨广泛应用于单相疲劳评估的疲劳严重程度量表（FSS）在重度抑郁症患者中的心理测量特性。
研究对象包括 72 名符合 DSM-IV 诊断标准的 M.I.N.I. 5.0.0 诊断的重度抑郁障碍患者，且无共患与疲劳相关的疾病，汉密尔顿抑郁评定量表（HDRS）得分≥17 分，以及 40 名性别和年龄匹配的健康对照者。在一周的间隔时间内，FSS 分别在患者和对照者身上进行两次评估。同时还评估了 36 项简明健康状况调查问卷（SF-36vit）的活力分量表和视觉模拟疲劳量表（VASF）。
根据 M.I.N.I.疲劳/能量损失条目，79.2%的患者为疲劳病例，而对照组为 15%。患者组的 FSS 评分分布呈负偏态，表明存在天花板效应。FSS 具有良好的测试-重测信度（组内相关系数 0.993）、内部一致性（Cronbach's α 系数 0.947）、同时效度（与 SF-36vit、VASF 和 HDRS 的相关性分别为-0.52、0.73 和 0.32）和患者与对照组之间的判别效度。因子分析显示具有单一维度结构。根据 M.I.N.I.作为“金标准”，对于临床上显著疲劳，FSS 的最佳截断值为 5.4。
在重度抑郁症患者中，FSS 表现出良好的心理测量特性，但存在天花板效应，这可能限制了其在该人群中的应用。
