Chronic fatigue in Hodgkin lymphoma survivors and associations with anxiety, depression and comorbidity

• Published in: British journal of cancer Vol. 110; no. 4; pp. 868 - 874
• Main Authors: Daniëls, L A, Oerlemans, S, Krol, A D G, Creutzberg, C L, van de Poll-Franse, L V
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 18.02.2014; Nature Publishing Group
• Subjects: 692/1807/1486; 692/699/476/1300; 692/699/476/1414; 692/699/67/1990/291/1556; Adult; Anxiety; Anxiety - epidemiology; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Chronic Disease - epidemiology; Clinical Study; Comorbidity; Cross-Sectional Studies; Depression - epidemiology; Drug Resistance; Epidemiology; Fatigue - epidemiology; Female; Hematologic and hematopoietic diseases; Hodgkin Disease - drug therapy; Hodgkin Disease - epidemiology; Hodgkin Disease - radiotherapy; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Molecular Medicine; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Oncology; Prevalence; Psychiatric Status Rating Scales; Quality of Life; Surveys and Questionnaires; Survivors; Tumors; anxiety; fatigue; cancer survivors; depression; quality of life; population based; Hodgkin lymphoma; Mood disorder; Human; Affect affectivity; Survivor; Depression; Fatigue; Hodgkin disease; Malignant hemopathy; Malignant tumor; Lymphoma; Chronic fatigue syndrome; Quality of life; Concomitant disease; Cancerology; Lymphoproliferative syndrome; Anxiety; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2013.779

Background: Fatigue is a frequent and persistent problem among Hodgkin lymphoma (HL) survivors. We investigated the prevalence of clinically relevant fatigue in HL survivors and the relation between fatigue and anxiety and depression. Methods: Fatigue was measured through the generic European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) and Fatigue Assessment Scale (FAS). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Questionnaires were mailed to 267 HL survivors. Results were compared with a Dutch age-matched normative population. Results: Response rate was 68% (median age 46 years, mean time since diagnosis 4.6 years). Prevalence of fatigue was significantly higher among HL survivors than in the norm population (FAS 41% vs 23%, QLQ-C30 43% vs 28%), as were fatigue levels. There was a significant association between fatigue, anxiety and depression. Of the HL survivors with high symptom levels of depression, 97% also reported fatigue. In multivariate analysis, depression was strongly associated with high levels of fatigue and, to a lesser extent, anxiety and comorbidity. Conclusions: Prevalence rates of fatigue are significantly higher in HL survivors than in the general population and differences are clinically relevant. Depression and anxiety were strongly associated with high levels of fatigue. Reducing fatigue levels by treatment of depression and anxiety should be further explored.