Vercoulen J H, Hommes O R, Swanink C M, Jongen P J, Fennis J F, Galama J M, van der Meer J W, Bleijenberg G
Department of Medical Psychology, University Hospital Nijmegen, The Netherlands.
Arch Neurol. 1996 Jul;53(7):642-9. doi: 10.1001/archneur.1996.00550070080014.
To provide a multidimensional characterization of fatigue in patients with multiple sclerosis (MS).
Cross-sectional design. Fifty patients with clinically definite MS were compared on the dimensions of fatigue with 51 patients with chronic fatigue syndrome (CFS) and 53 healthy subjects.
Fourty-six percent of the patients with MS reported fatigue to be present at least once a week. Patients with MS and patients with CFS had significantly higher subjective fatigue severity scores than healthy subjects. Patients with MS and patients with CFS had significantly higher scores on measures of psychological well-being than healthy subjects. Patients with MS had scores similar to those of patients with CFS, except that patients with CFS had significantly higher somatization scores. High somatization scores reflect strong focusing on bodily sensations. Both groups of patients were significantly less active than the healthy subjects. The Kurtzke Expanded Disability Status Scale (EDSS) and the Beck Depression Inventory scores were not related to subjective fatigue severity. In patients with MS and in patients with CFS, subjective fatigue severity was related to impairment in daily life, low sense of control over symptoms, and strong focusing on bodily sensations. In CFS, but not in MS, evidence was found for a relationship between low levels of physical activity and attributing symptoms to a physical cause and between subjective fatigue severity and physical activity.
Patients with MS experienced significant fatigue, which had a significant impact on daily functioning and was not related to depression on Expanded Disability Status Scale score. Psychological factors, such as focusing on bodily sensations and low sense of control play a role in the experience of fatigue in MS and CFS.
对多发性硬化症（MS）患者的疲劳进行多维度特征描述。
横断面设计。将50例临床确诊的MS患者在疲劳维度上与51例慢性疲劳综合征（CFS）患者和53名健康受试者进行比较。
46%的MS患者报告疲劳至少每周出现一次。MS患者和CFS患者的主观疲劳严重程度得分显著高于健康受试者。MS患者和CFS患者在心理健康测量方面的得分显著高于健康受试者。MS患者的得分与CFS患者相似，只是CFS患者的躯体化得分显著更高。高躯体化得分反映了对身体感觉的强烈关注。两组患者的活动量均显著低于健康受试者。Kurtzke扩展残疾状态量表（EDSS）得分和贝克抑郁量表得分与主观疲劳严重程度无关。在MS患者和CFS患者中，主观疲劳严重程度与日常生活受损、对症状的控制感低以及对身体感觉的强烈关注有关。在CFS中，但在MS中未发现，低体力活动水平与将症状归因于身体原因之间以及主观疲劳严重程度与体力活动之间存在关联。
MS患者经历了显著的疲劳，这对日常功能有显著影响，且与扩展残疾状态量表得分所反映的抑郁无关。心理因素，如对身体感觉的关注和低控制感，在MS和CFS的疲劳体验中起作用。
