Susan Carroll1, Trudie Chalder2, Cheryl Hemingway3, Isobel Heyman4, Holly Bear1, Louise Sweeney1, Rona Moss-Morris5. 1. Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK. 2. Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK. 3. Department of Neurology, Great Ormond Street Hospital for Children, London, UK; UCL, Institute of Child Health, Guildford Street, London, UK. 4. Department of Psychological Medicine, Great Ormond Street Hospital for Children, London, UK; UCL, Institute of Child Health, Guildford Street, London, UK. 5. Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK. Electronic address: rona.moss-morris@kcl.ac.uk.
Abstract
BACKGROUND: Fatigue is a disabling, poorly understood symptom in children and adolescents with multiple sclerosis (caMS), for which effective treatments are lacking. In paediatric Chronic Fatigue Syndrome (CFS), effective psychological interventions have been developed based on psychosocial factors associated with fatigue. This study aimed to identify potentially modifiable factors of fatigue in caMS by comparing caMS, adolescents with CFS, healthy adolescents and their parents on measures of fatigue, psychosocial factors, and neurocognitive functioning. METHODS: 175 participants including 30 caMS (15 fatigued, 15 non-fatigued), 30 adolescents with CFS, 30 healthy controls, and their parents were compared on measures of self- and parent-reported fatigue, adolescent and parent cognitive behavioural responses to symptoms, sleep, psychological difficulties, parental distress and objectively measured neurocognitive functioning. RESULTS: Fatigue severity, functional impairment and cognitive behavioural responses to symptoms were equivalent in fatigued caMS and adolescents with CFS, and were significantly higher than in healthy controls and non-fatigued caMS. Neurocognitive functioning was impaired in both caMS groups, but was normal in adolescents with CFS and healthy controls. No between-group differences were identified in adolescent sleep behaviour or psychological difficulties. Parents of all illness groups had more unhelpful cognitions than parents of healthy controls. Psychological distress was elevated in parents of both fatigued groups. CONCLUSIONS: Fifty percent of caMS reported clinically significant fatigue. Similarities between adolescent and parent cognitive behavioural factors in fatigued caMS and adolescents with CFS suggest important potential targets for intervention. Both fatigued and non-fatigued caMS had cognitive difficulties, suggesting that fatigue may need targeted intervention. Crown
BACKGROUND:Fatigue is a disabling, poorly understood symptom in children and adolescents with multiple sclerosis (caMS), for which effective treatments are lacking. In paediatric Chronic Fatigue Syndrome (CFS), effective psychological interventions have been developed based on psychosocial factors associated with fatigue. This study aimed to identify potentially modifiable factors of fatigue in caMS by comparing caMS, adolescents with CFS, healthy adolescents and their parents on measures of fatigue, psychosocial factors, and neurocognitive functioning. METHODS: 175 participants including 30 caMS (15 fatigued, 15 non-fatigued), 30 adolescents with CFS, 30 healthy controls, and their parents were compared on measures of self- and parent-reported fatigue, adolescent and parent cognitive behavioural responses to symptoms, sleep, psychological difficulties, parental distress and objectively measured neurocognitive functioning. RESULTS:Fatigue severity, functional impairment and cognitive behavioural responses to symptoms were equivalent in fatigued caMS and adolescents with CFS, and were significantly higher than in healthy controls and non-fatigued caMS. Neurocognitive functioning was impaired in both caMS groups, but was normal in adolescents with CFS and healthy controls. No between-group differences were identified in adolescent sleep behaviour or psychological difficulties. Parents of all illness groups had more unhelpful cognitions than parents of healthy controls. Psychological distress was elevated in parents of both fatigued groups. CONCLUSIONS: Fifty percent of caMS reported clinically significant fatigue. Similarities between adolescent and parent cognitive behavioural factors in fatigued caMS and adolescents with CFS suggest important potential targets for intervention. Both fatigued and non-fatigued caMS had cognitive difficulties, suggesting that fatigue may need targeted intervention. Crown
Authors: I L Klein; K F E van de Loo; T J Hoogeboom; M C H Janssen; J A M Smeitink; E van der Veer; C M Verhaak; J A E Custers Journal: Trials Date: 2021-03-01 Impact factor: 2.279
Authors: Niels Kramer; Sanne L Nijhof; Elise M van de Putte; Marjolijn Ketelaar; Martha A Grootenhuis; Kors van der Ent; Joost F Swart; Martine van Grotel; Geertje W Dalmeijer; Merel M Nap-van der Vlist Journal: BMJ Paediatr Open Date: 2021-05-21