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Article

The Effect of Depression on Health-Related Quality of Life Is Mediated by Fatigue in Persons with Multiple Sclerosis

1
Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), 8001 Zurich, Switzerland
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Department of Neurology, Schulthess Clinic, 8008 Zürich, Switzerland
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Department of Health Sciences and Technology, Eidgenössische Technische Hochschule (ETH) Zurich, 8092 Zürich, Switzerland
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Division of Molecular and Cognitive Neuroscience, University of Basel, 4055 Basel, Switzerland
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Department of Neurology, Inselspital, Bern University Hospital and University of Bern, 3010 Bern, Switzerland
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Department of Neurology and Neurorehabilitation, Rehabilitation Centre Kliniken Valens, 7317 Valens, Switzerland
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Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, 6000 Lucerne, Switzerland
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Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital and University of Basel, 4031 Basel, Switzerland
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Department of Neurology, Multiple Sclerosis Center (MSC), Neurocenter of Southern Switzerland, 6900 Lugano, Switzerland
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Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
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Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich (PUK), 8032 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Academic Editor: Bruno Brochet
Brain Sci. 2021, 11(6), 751; https://doi.org/10.3390/brainsci11060751
Received: 10 May 2021 / Accepted: 1 June 2021 / Published: 5 June 2021
The interrelations between fatigue, depression and health-related quality of life (HRQoL) in persons with multiple sclerosis (PwMS) are complex, and the directionality of the effects is unclear. To address this gap, the current study used a longitudinal design to assess direct and indirect effects of fatigue and depression on HRQoL in a one-year follow-up survey. A sample of 210 PwMS from the nationwide Swiss MS Registry was used. HRQoL was assessed using the European Quality of Life 5-Dimension 5-Level questionnaire. Path analysis on HRQoL, with fatigue and depression as predictors, was applied. Fatigue was measured by the Modified Fatigue Impact Scale (MFIS), including physical, cognitive and psychosocial subscales, and non-somatic depressive symptomatology was examined with the Beck Depression Inventory-Fast Screen (BDI-FS). Fatigue acted as a fully mediating variable (B = −0.718, SE = 0.253) between non-somatic depressive symptomatology and HRQoL. This indirect effect became apparent in the physical (B = −0.624, SE = 0.250), psychosocial (B = −0.538, SE = 0.256) and cognitive subscales (B = −0.485, SE = 0.192) of fatigue. In contrast, non-somatic depressive symptomatology did not act as a mediator. Our findings provide novel and clinically relevant longitudinal evidence showing that the debilitating effect of non-somatic aspects of depression on HRQoL was fully mediated and therefore explainable via fatigue. View Full-Text
Keywords: multiple sclerosis; quality of life; depression; fatigue; longitudinal multiple sclerosis; quality of life; depression; fatigue; longitudinal
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MDPI and ACS Style

Rodgers, S.; Manjaly, Z.-M.; Calabrese, P.; Steinemann, N.; Kaufmann, M.; Salmen, A.; Chan, A.; Kesselring, J.; Kamm, C.P.; Kuhle, J.; Zecca, C.; Gobbi, C.; von Wyl, V.; Ajdacic-Gross, V. The Effect of Depression on Health-Related Quality of Life Is Mediated by Fatigue in Persons with Multiple Sclerosis. Brain Sci. 2021, 11, 751. https://doi.org/10.3390/brainsci11060751

AMA Style

Rodgers S, Manjaly Z-M, Calabrese P, Steinemann N, Kaufmann M, Salmen A, Chan A, Kesselring J, Kamm CP, Kuhle J, Zecca C, Gobbi C, von Wyl V, Ajdacic-Gross V. The Effect of Depression on Health-Related Quality of Life Is Mediated by Fatigue in Persons with Multiple Sclerosis. Brain Sciences. 2021; 11(6):751. https://doi.org/10.3390/brainsci11060751

Chicago/Turabian Style

Rodgers, Stephanie, Zina-Mary Manjaly, Pasquale Calabrese, Nina Steinemann, Marco Kaufmann, Anke Salmen, Andrew Chan, Jürg Kesselring, Christian P. Kamm, Jens Kuhle, Chiara Zecca, Claudio Gobbi, Viktor von Wyl, and Vladeta Ajdacic-Gross. 2021. "The Effect of Depression on Health-Related Quality of Life Is Mediated by Fatigue in Persons with Multiple Sclerosis" Brain Sciences 11, no. 6: 751. https://doi.org/10.3390/brainsci11060751

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