Fatigue and Psychiatric Morbidity Among Hodgkin's Disease Survivors

• Published in: Journal of pain and symptom management Vol. 19; no. 2; pp. 91 - 99
• Main Authors: Loge, Jon Håvard, Abrahamsen, Arne Foss, Ekeberg, Øivind, Kaasa, Stein
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2000; Elsevier Science
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Anxiety; Biological and medical sciences; depression; Fatigue; Female; Hematologic and hematopoietic diseases; Hodgkin Disease - physiopathology; Hodgkin Disease - psychology; Hodgkin's disease; Humans; Male; Medical sciences; Mental Disorders - epidemiology; Middle Aged; Miscellaneous; Morbidity; neoplasms/psychology; Other diseases. Hematologic involvement in other diseases; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Surveys and Questionnaires; neoplasms/psychology; fatigue; Anxiety; depression; Hodgkin's disease; Mood disorder; Human; Lymphoproliferative syndrome; Depression; Fatigue; Hodgkin disease; Malignant hemopathy; Psychopathology; Lymphoma
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/S0885-3924(99)00148-7

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.