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Measurement and prediction of subjective fatigue following traumatic brain injury

Published online by Cambridge University Press:  01 July 2005

CARLO ZIINO  and
JENNIE PONSFORD
CARLO ZIINO
Affiliation:
Department of Psychology, Monash University, Australia
JENNIE PONSFORD
Affiliation:
Department of Psychology, Monash University, Australia Monash-Epworth Rehabilitation Research Centre, Australia
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Abstract

Numerous outcome studies have found fatigue to be a common problem following traumatic brain injury (TBI). This study examined the magnitude, causes and impact of fatigue following TBI using three subjective fatigue scales, and investigated its relationship with demographic and injury-related factors, and mood. Forty-nine controls and 49 TBI participants (36.2% with GCS score of 13–15, 29.8% with GCS score of 9–12, and 34% with GCS score of 3–8) were seen at a mean of approximately 8 months post injury. All participants completed three subjective fatigue measures, including the Fatigue Severity Scale (FSS), Visual Analogue Scale–Fatigue (VAS–F) and Causes of Fatigue Questionnaire (COF). TBI participants reported a significantly greater impact of fatigue on their lifestyle on the FSS relative to controls, and reported activities requiring physical and mental effort as more frequent causes of fatigue on the COF. There were, however, no significant group differences on subscales of the VAS–F. Greater time since injury and higher education levels were associated with higher fatigue levels, independent of the effects of mood. Injury severity and age were not found to be significant predictors of subjective fatigue severity in TBI participants. (JINS, 2005, 11, 416–425.)

Keywords

FatigueClosed head injuriesBrain injuriesDepressionAnxiety
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 4 , July 2005 , pp. 416 - 425
Copyright
© 2005 The International Neuropsychological Society

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References

REFERENCES

Aaronson, L.S., Pallikkathayil, L., & Crighton, F. (2003). A qualitative investigation of fatigue among healthy working adults. Western Journal of Nursing Research, 25, 419–433.CrossRefGoogle Scholar
Aaronson, L.S., Teel, C.S., Cassmeyer, V., Neuberger, G.B., Pallikkathayil, L., Pierce, J., Press, A.N., Williams, P.D., & Wingate, A. (1999). Defining and measuring fatigue. Image–The Journal of Nursing Scholarship, 31, 45–50.CrossRefGoogle Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Beenen, L.F.M., Lindeboom, J., Kasteleijn-Nolst Trenite, D.G.A., Heimans, J.J., Snoek, F.J., Touw, D.J., Ader, H.J., & van Alphen, H.A.M. (1999). Comparative double blind clinical trial of phenytoin and sodium valproate as anticonvulsant prophylaxis after craniotomy: Efficacy, tolerability and cognitive effects. Journal of Neurology, Neurosurgery & Psychiatry, 67, 474–480.CrossRefGoogle Scholar
Belza, B.L., Henke, C.J., Yelin, E.H., Epstein, W.V., & Gillis, C.L. (1993). Correlates of fatigue in older adults with rheumatoid arthritis. Nursing Research, 42, 93–99.Google Scholar
Bensing, J.M., Hulsman, R.L., & Schreurs, K.M.G. (1999). Gender differences in fatigue: Biopsychosocial factors relation to fatigue in men and women. Medical Care, 37, 1078–1083.CrossRefGoogle Scholar
Bruce, I.N., Hallett, D.C., Gladman, D.D., Urowitz, M.B., & Mak, V.C. (1999). Factors associated with fatigue in patients with systemic lupus erythematosus. Annals of the Rheumatic Disease, 58, 379–381.CrossRefGoogle Scholar
Caci, H., Bayle, F.J., Mattei, V., Dossios, C., Robert, P., & Boyer, P. (2003). How does the hospital and anxiety and depression scale measure anxiety and depression in healthy subjects? Psychiatry Research, 118, 89–99.Google Scholar
Cattelani, R., Tanzi, F., Lombardi, F., & Mazzucchi, A. (2002). Competitive re-employment after severe traumatic brain injury: Clinical, cognitive and behaviour predictor variables. Brain Injury, 16, 51–64.CrossRefGoogle Scholar
Chalder, T., Berelowitz, G., Pawlikowska, T., & Watts, L. (1993). Development of a fatigue scale. Journal of Psychosomatic Research, 37, 147–153.CrossRefGoogle Scholar
Cooke, K.M., Kreydatus, M.A., Atherton, A., & Thoman, E.B. (1998). The effects of evening light exposure on the sleep of elderly women expressing sleep complaints. Journal of Behavioral Medicine, 21, 103–114.CrossRefGoogle Scholar
DeVries, J., Michielsen, H.J., & Van Heck, G.L. (2003). Assessment of fatigue among working people: A comparison of six questionnaires. Occupational and Environmental Medicine, 60(Suppl. 1), i10–i15.CrossRefGoogle Scholar
Dikmen, S., Machamer, J., & Temkin, N. (1993). Psychological outcome in patients with moderate to severe brain injury. Brain Injury, 7, 113–124.CrossRefGoogle Scholar
Doig, E., Fleming, J., & Tooth, L. (2001). Patterns of community integration 2–5 years post-discharge from brain injury rehabilitation. Brain Injury, 15, 747–762.CrossRefGoogle Scholar
Ettinger, A.B., Weisbrot, D.M., Krupp, L.B., Coyle, P.K., Jandorf, L., & Devinsky, O. (1998). Fatigue and depression in epilepsy. Journal of Epilepsy, 11, 105–109.CrossRefGoogle Scholar
Evans, R.W. (1992). The post-concussion syndrome and sequelae of mild head injury. Neurologica Clinics, 10, 815–847.CrossRefGoogle Scholar
Ferrell, B.R., Grant, M., Dean, G.E., Funk, B., & Ly, J. (1996). “Bone tired”: The experience of fatigue and its impact on quality of life. Oncology Nursing Forum, 23, 1539–1547.Google Scholar
Fishbain, D.A., Cole, B., Cutler, R.B., Lewis, J., Rosomoff, H.L., & Steele Rosomoff, R. (2003). Is pain fatiguing? A structured evidence-based review. Pain Medicine, 4, 51–62.CrossRefGoogle Scholar
Fisk, J.D., Ritvo, R.G., Ross, L., Haase, D.A., Mattie, T.J., & Schlech, W.F. (1994). Measuring the functional impact of fatigue: Initial validation of the fatigue impact scale. Clinical Infectious Diseases, 18(Suppl. 1), S79–S83.CrossRefGoogle Scholar
Fleming, J., Tooth, L., Hassell, M., & Chan, W. (1999). Prediction of community integration and vocational outcome 2–5 years after traumatic brain injury rehabilitation in Australia. Brain Injury, 6, 417–431.Google Scholar
Fuhrer, R. & Wessely, S. (1995). The epidemiology of fatigue and depression: A French primary-care study. Psychological Medicine, 25, 895–905.CrossRefGoogle Scholar
Gaudino, E.A., Coyle, P.K., & Krupp, L.B. (1997). Post-lyme syndrome and chronic fatigue syndrome. Archives of Neurology, 54, 1372–1376.CrossRefGoogle Scholar
Gibson, J. & Edwards, R.H. (1985). Muscular exercise and fatigue. Sports Medicine, 2, 120–132.CrossRefGoogle Scholar
Hann, D.M., Jacobsen, P.B., Azzarello, L.M., Martin, S.C., Curran, S.L., Fields, K.K., Greenberg, H., & Lyman, G. (1998). Measurement of fatigue in cancer patients: Development and validation of the fatigue symptom inventory. Quality of Life Research, 7, 301–310.CrossRefGoogle Scholar
Harter, M., Reuter, K., Gross-Hardt, K., & Bengel, J. (2001). Screening for anxiety, depressive and somatoform disorders in rehabilitation. Validity of HADS and GHQ-12 in patients with musculoskeletal disease. Disability and Rehabilitation, 23, 737–744.Google Scholar
Hayashi, M., Watanabe, M., & Hori, T. (1999). The effects of a 20 min nap in the mid-afternoon on mood, performance and EEG activity. Clinical Neurophysiology, 110, 272–279.CrossRefGoogle Scholar
Hellawell, D.J., Taylor, R.T., & Pentland, B. (1999). Cognitive and psychosocial outcome following moderate or severe traumatic brain injury. Brain Injury, 13, 489–504.CrossRefGoogle Scholar
Herlofson, K. & Larsen, J.P. (2002). Measuring fatigue in patients with Parkinson's disease—the fatigue severity scale. European Journal of Neurology, 9, 595–600.CrossRefGoogle Scholar
Hibbard, M.R., Uysal, S., Kepler, K., Bogdany, J., & Silver, J. (1998). Axis I psychopathology in individuals with traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 24–39.CrossRefGoogle Scholar
Hill, B., Ponsford, J., Hart, P., & Sanders, R. (2001, August). Factors influencing outcome following orthopaedic trauma. Paper presented at the Innovations in Rehabilitation Conference, Melbourne, Australia.
Jones, R.K. (1974). Assessment of minimal head injuries: Indications for in-hospital care. Surgical Neurology, 2, 101–104.Google Scholar
Keyser-Marcus, L.A., Bricout, J.C., Wehman, P., Campbell, L.R., Cifu, D.X., Englander, J., High, W., & Zafonte, R.D. (2002). Acute predictors of return to employment after traumatic brain injury: A longitudinal follow-up. Archives of Physical Medicine and Rehabilitation, 83, 635–641.CrossRefGoogle Scholar
Kreutzer, J.S., Seel, R.T., & Gourley, E. (2001). The prevalence and symptom rates of depression after traumatic brain injury: A comprehensive examination. Brain Injury, 15, 563–576.CrossRefGoogle Scholar
Krupp, L.B., Coyle, P.K., Doscher, C., Miller, A., Cross, A.H., Jandorf, L., Halper, J., Johnson, B., Morgante, L., & Grimson, R. (1995). Fatigue therapy in multiple sclerosis. Neurology, 45, 1956–1961.CrossRefGoogle Scholar
Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 1121–1123.CrossRefGoogle Scholar
LaChapelle, D.L. & Finlayson, M.A.J. (1998). An evaluation of subjective and objective measures of fatigue in patients with brain injury and healthy controls. Brain Injury, 12, 649–659.CrossRefGoogle Scholar
Lavidor, M., Weller, A., & Babkoff, H. (2003). How sleep is related to fatigue. British Journal of Health Psychology, 8, 95–105.CrossRefGoogle Scholar
Lee, K.A., Hicks, G., & Nino-Murcia, G. (1991). Validity and reliability of a scale to assess fatigue. Psychiatry Research, 36, 291–298.CrossRefGoogle Scholar
Lewis, G. & Wessely, S. (1992). The epidemiology of fatigue: More questions than answers. Journal of Epidemiology and Community Health, 46, 92–97.CrossRefGoogle Scholar
Lichstein, K.L., Means, M.K., Noe, S.L., & Aguillard, R.N. (1997). Fatigue and sleep disorders. Behavioural Research and Therapy, 35, 733–740.CrossRefGoogle Scholar
Masson, F., Maurette, P., Salmi, L.R., Dartigues, J.F., Vecsey, J., Destaillats, J.M., & Erny, P. (1996). Prevalence of impairments 5 years after a head injury, and their relationship with disabilities and outcome. Brain Injury, 10, 487–497.CrossRefGoogle Scholar
McNair, D.M., Lorr, M., & Droppleman, L.F. (1981). Edits manual: Profile of mood states. San Diego, CA: Educational and Industrial Testing Service.
Meek, P.M., Nail, L.M., Barsevick, A., Schwartz, A.L., Stephen, S., Whitmer, K., Beck, S.L., Jones, L.S., & Walker, B.L. (2000). Psychometric testing of fatigue instruments for use with cancer patients. Nursing Research, 49, 181–190.CrossRefGoogle Scholar
Mendoza, T., Wang, X., Cleeland, C., Morrissey, M., Johnson, B., & Wendt, J. (1999). The rapid assessment of fatigue severity in cancer patients: Use of a brief fatigue inventory. Cancer, 85, 1186–1196.3.0.CO;2-N>CrossRefGoogle Scholar
Middleboe, T., Anderson, H.H., Birket-Smith, M., & Friis, M.L. (1992). Minor head injury: Impact on general health after 1 year: A prospective follow-up study. Acta Neurologica Scandinavica, 85, 5–9.CrossRefGoogle Scholar
MIMS Australia. (2004). 2004 MIMS annual. Sydney: MIMS Australia.
Morriss, R.K., Wearden, A.J., & Battersby, L. (1997). The relation of sleep difficulties to fatigue, mood and disability in chronic fatigue syndrome. Journal of Psychosomatic Research, 42, 597–605.CrossRefGoogle Scholar
Nelson, H.E. & Willison, J. (1991). The national adult reading test (NART): Test manual (2nd ed.). Windsor: NFER–Nelson.
Olver, J.H., Ponsford, J.L., & Curran, C. (1996). Outcomes following traumatic brain injury: A comparison between 2 and 5 years after injury. Brain Injury, 10, 841–848.CrossRefGoogle Scholar
Pawlikowska, T., Chalder, T., Hirsch, S.R., Wallace, P., Wright, D.J.M., & Wessely, S.C. (1994). Population based study of fatigue and psychological distress. British Medical Journal, 308, 763–766.CrossRefGoogle Scholar
Piper, B.F. (1989). Fatigue: Current bases for practice. In S.G. Funk, E.M. Torniquist, M.T. Champagne, L.A. Copp, & R. Wiese (Eds.), Key aspects of comfort (pp. 197–198). New York: Springer.
Piper, B.F., Lindsay, A.M., Dodd, M.J., Ferketich, S., Paul, S.M., & Weller, S. (1989). The development of an instrument to measure the subjective dimensions of fatigue. In S.G. Funk, E.M. Torniquist, M.T. Champagne, L.A. Copp, & R. Wiese (Eds.), Key aspects of comfort (pp. 199–209). New York: Springer.
Pollina, D., Kaufman, L.D., Masur, D.M., & Krupp, L.B. (1998). Pain, fatigue, and sleep in eosinophilia–myalgia syndrome: Relationship to neuropsychological performance. Journal of Neuropsychiatry and Clinical Neurosciences, 10, 338–342.CrossRefGoogle Scholar
Ponsford, J., Olver, J.H., & Curran, C. (1995). A profile of outcome: 2 years after traumatic brain injury. Brain Injury, 9, 1–10.CrossRefGoogle Scholar
Ponsford, J.L. (1995). Mechanisms, recovery and sequelae of traumatic brain injury: A foundation for the REAL approach. In J.L. Ponsford (Ed.), Traumatic brain injury: Rehabilitation for everyday adaptive living (pp. 1–31). Hove, UK: Psychology Press Ltd.
Rammohan, K.W., Rosenberg, J.H., Lynn, D.J., Blumenfeld, A.M., Pollak, C.P., & Nagaraja, H.N. (2002). Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: A two centre phase 2 study. Journal of Neurology, Neurosurgery & Psychiatry, 72, 179–183.CrossRefGoogle Scholar
Ream, E.K. & Richardson, A. (1996). Fatigue: A concept analysis. International Journal of Nursing Studies, 33, 519–529.CrossRefGoogle Scholar
Reyes-Gibby, C.C., Mendoza, T.R., Wang, X.S., Anderson, K.O., & Cleeland, C.S. (2003). Pain and fatigue in community-dwelling adults. Pain Medicine, 4, 231–237.CrossRefGoogle Scholar
Ridsdale, L., Evans, A., Jerrett, W., Mandalia, S., Osler, K., & Vora, H. (1993). Patients with fatigue in general practice: A prospective study. British Medical Journal, 307, 103–106.CrossRefGoogle Scholar
Salinsky, M., Oken, B., & Binder, L. (1996). Assessment of drowsiness in epilepsy patients receiving chronic antiepileptic drug therapy. Epilepsia, 37, 181–187.CrossRefGoogle Scholar
Schwartz, J.E., Jandorf, L., & Krupp, L.B. (1993). The measurement of fatigue: A new instrument. Journal of Psychosomatic Research, 37, 753–762.CrossRefGoogle Scholar
Schwartz, T.L., Azhar, N., Cole, K., Hopkins, G., Nihalani, N., Simionescu, M., Husain, J., & Jones, N. (2004). An open-label study of adjunctive modafinil in patients with sedation related to serotonergic antidepressant therapy. Journal of Clinical Psychiatry, 65, 1223–1227.CrossRefGoogle Scholar
Schwarz, R., Krauss, O., & Hinz, A. (2003). Fatigue in the general population. Onkologie, 26, 140–144.CrossRefGoogle Scholar
Seel, R.T., Kreutzer, J.S., Rosenthal, M., Hammond, M., Corrigan, J.D., & Black, K. (2003). Depression after traumatic brain injury: A national institute of disability and rehabilitation research model systems multicenter investigation. Archives of Physical Medicine and Rehabilitation, 84, 177–184.CrossRefGoogle Scholar
Sherer, M., Nick, T.G., Sander, A.M., Hart, T., Hanks, R., Rosenthal, M., High, W.M., & Yablon, S.A. (2003). Race and productivity outcome after traumatic brain injury: Influence of confounding factors. Journal of Head Trauma Rehabilitation, 18, 408–424.CrossRefGoogle Scholar
Sherer, M., Sander, A.M., Nick, T.G., High, W.M., Malec, J.F., & Rosenthal, M. (2002). Early cognitive status and productivity outcome after traumatic brain injury: Findings from the TBI model. Archives of physical medicine and rehabilitation, 83, 183–192.CrossRefGoogle Scholar
Shores, E.A., Marosszeky, J.E., Sandanam, J., & Batchelor, J. (1986). Preliminary validation of a scale for measuring the duration of post-traumatic amnesia. Medical Journal of Australia, 144, 569–572.Google Scholar
Smets, E.M., Garssen, B., Bonke, B., & de Haes, J.C. (1995). The multidimensional fatigue inventory (MFI): Psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research, 39, 315–325.CrossRefGoogle Scholar
Smets, E.M., Garssen, B., Schuster-Uitterhoeve, A.L.J., & deHaes, J.C.J.M. (1993). Fatigue in cancer patients. British Journal of Cancer, 68, 220–224.CrossRefGoogle Scholar
Snaith, R.P. & Zigmond, A.S. (1994). The Hospital Anxiety and Depression Scale with the Irritability Depression-Anxiety Scale and the Leeds Situational Anxiety Scale: Manual. Windsor, UK: NFER-Nelson.
Spigset, O. (1999). Adverse reactions of selective serotonin reuptake inhibitors: Reports from a spontaneous reporting system. Drug Safety, 20, 277–287.CrossRefGoogle Scholar
Stuss, D.T., Stethem, L.L., Hugenholtz, H., Picton, T., Pivik, J., & Richard, M.T. (1989). Reaction time after head injury: Fatigue, divided attention and focused attention, and consistency of performance. Journal of Neurology, Neurosurgery & Psychiatry, 52, 742–748.CrossRefGoogle Scholar
Tench, C.M., McCarthy, J., McCurdie, I., White, P.D., & D'Cruz, D.P. (2003). Fatigue in systemic lupus erythematosus: A randomized controlled trial of exercise. Rheumatology, 42, 1050–1054.CrossRefGoogle Scholar
Tench, C.M., McCurdie, I., White, P.D., & D'Cruz, D.P. (2000). The prevalence and associations of fatigue in systemic lupus erythematosus. Rheumatology, 39, 1249–1254.CrossRefGoogle Scholar
van der Naalt, J., van Zomeren, A.H., Sluiter, W.J., & Minderhoud, J.M. (1999). One year outcome in mild to moderate head injury: The predictive value of acute injury characteristics related to work complaints and return to work. Journal of Neurology, Neurosurgery & Psychiatry, 66, 207–213.CrossRefGoogle Scholar
van Zomeren, A.H., Brouwer, W.H., & Deelman, B.G. (1984). Attentional deficits: The riddles of selectivity, speed and alertness. In D. Brooks (Ed.), Closed head injury: Psychological, social and family consequences (pp. 74–107). Oxford, UK: Oxford University Press.
van Zomeren, A.H. & van den Burg, W. (1985). Residual complaints of patients two years after severe head injury. Journal of Neurology, Neurosurgery & Psychiatry, 48, 21–28.CrossRefGoogle Scholar
Vitaz, T.W., Jenks, J., Raque, G.H., & Shields, C.B. (2003). Outcome following moderate traumatic brain injury. Surgical Neurology, 60, 285–291.CrossRefGoogle Scholar
Wade, A., Crawford, G.M., Angus, M., Wilson, R., & Hamilton, L. (2003). A randomized, double-blind, 24-week study comparing the efficacy and tolerability of mirtazapine and paroxetine in depressed patients in primary care. International Clinical Psychopharmacology, 18, 133–141.Google Scholar
Walker, G.C., Cardenas, D.D., Guthrie, M.R., McLean, A., & Brooke, M.M. (1991). Fatigue and depression in brain injured patients correlated with quadriceps strength and endurance. Archives of Physical Medicine and Rehabilitation, 72, 469–472.Google Scholar
Wessely, S., Chalder, T., Hirsch, S.R., Pawlikowska, T., Wallace, P., & Wright, D.J.M. (1995). Postinfectious fatigue: Prospective cohort study in primary care. Lancet, 345, 1333–1338.CrossRefGoogle Scholar
Winstead-Fry, P. (1998). Psychometric assessment of four fatigue scales with a sample of rural cancer patients. Journal of Nursing Measurement, 6, 111–122.Google Scholar