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- Title
Early Treatment Improvements in Depression Are Associated With Overall Improvements in Fatigue Impact and Pain Interference in Adults With Multiple Sclerosis.
- Authors
Knowles, Lindsey M; Arewasikporn, Anne; Kratz, Anna L; Turner, Aaron P; Alschuler, Kevin N; Ehde, Dawn M
- Abstract
<bold>Background: </bold>Depression, fatigue, and pain commonly co-occur in multiple sclerosis (MS) and are positively associated with one another. However, it is unclear whether treatment-related improvement in one of these symptoms is associated with improvements in the other two symptoms.<bold>Purpose: </bold>This study examined whether early improvements in depressive symptoms, fatigue impact, and pain interference during a multisymptom intervention in persons with MS were associated with overall improvements in the other two symptoms.<bold>Methods: </bold>Secondary analysis of a randomized controlled trial in which both treatments improved depressive symptoms, fatigue, and pain interference. Adults with MS experiencing chronic pain, chronic fatigue, and/or moderate depressive symptoms (N = 154, 86% women) participated in an 8-week, telephone-delivered intervention: self-management (n = 69) or education (n = 85); intervention groups were combined for the current study. Outcome measures were depressive symptoms (PHQ-9), fatigue impact (Modified Fatigue Impact Scale), and pain interference (Brief Pain Inventory). Path analysis examined associations between pre-to-mid intervention improvement in one symptom (i.e., depression, fatigue, pain interference) and pre-to-post (overall) improvement in the other two symptoms.<bold>Results: </bold>Early reduction in depressive symptoms was associated with an overall reduction in pain interference and fatigue impact (p's < .01). Early reduction in fatigue impact was associated with an overall reduction in depressive symptom severity (p = .04) but not pain interference. Early reduction in pain interference was not associated with reductions in fatigue impact or depressive symptoms.<bold>Conclusions: </bold>These findings suggest the potential importance of reducing depressive symptoms to overall improvement in fatigue and pain interference in persons with MS.<bold>Clinical Trial Registrations: </bold>NCT00944190.
- Subjects
MULTIPLE sclerosis; MENTAL depression; PAIN; BRIEF Pain Inventory; SYMPTOMS; PAIN management; MULTIPLE personality; CANCER fatigue
- Publication
Annals of Behavioral Medicine, 2021, Vol 55, Issue 9, p833
- ISSN
0883-6612
- Publication type
journal article
- DOI
10.1093/abm/kaaa102