The Utility of Selected Questionnaires in the Assessment of Fatigue, Depression and Health Quality in Post-Sarcoidosis Fatigue Syndrome

Abstract

Introduction: The nature of post-sarcoidosis fatigue syndrome (PSFS) is unknown and tools for the assessment of health quality (HQ) in these patients have not been fully assessed. The aim was to validate the Polish version of sarcoidosis health questionnaire (SHQ) and verify the association of HQ with fatigue and depressive symptoms among Polish patients with PSFS. Material and methods: 71 patients with sarcoidosis (34 women, the mean age 47) were divided to: PSFS (n = 21), active sarcoidosis (S-A, n = 27) and sarcoidosis with complete remission (S-R, n = 23) groups. Fatigue Assessment Scale (FAS) was used to define significant fatigue (≥ 22 points). Polish version of SHQ was prepared by the authors and validated. Beck Depression Index (BDI) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate self-reported depressive symptoms. Results: Polish version of SHQ was proved reliable and valid. HQ was worse and depressive symptoms were more frequent in PSFS and S-A when compared with S-R group. SHQ total score correlated negatively with depressive symptoms (r = -0.787 for BDI and r = -0,755 for PHQ-9, p < 0.01). A negative correlation between SHQ and FAS score was found (r = -0.784, p < 0.01). FAS score correlated with depressive symptoms (r = 0.726 for BDI and r = 0.755 for PHQ-9, p < 0.01). Conclusion: Polish version of SHQ is a valuable tool for the assessment of HQ in sarcoidosis. HQ is impaired in PSFS comparing to patients with complete remission, but is comparable to active sarcoidosis. Depressive symptoms impact HQ and may influence perception of fatigue. Both fatigue and depression have a negative impact on HQ in sarcoidosis.

Psychological burden associated with worse clinical outcomes in sarcoidosis

“…Our findings of psychological symptoms being associated with worse HRQoL confirms previous studies that have found a correlation between HRQoL and depressive symptoms in sarcoidosis18 19 and an association between symptom severity and anxiety 11. However, our study included covariates such as organ involvement and comorbidities which have not been included in previous studies.…”

“…In other chronic pulmonary illnesses, psychological symptoms are associated with lower health-related quality of life (HRQoL) independent of disease severity 15–17. Depressive symptoms have been correlated with lower HRQoL in patients with sarcoidosis; however, these studies have not evaluated the association while controlling for other factors such as disease severity 10 18 19. The previous studies have included those with sarcoidosis requiring medication and those with asymptomatic sarcoidosis or sarcoidosis not requiring medication 10 18 19.…”

“…Depressive symptoms have been correlated with lower HRQoL in patients with sarcoidosis; however, these studies have not evaluated the association while controlling for other factors such as disease severity 10 18 19. The previous studies have included those with sarcoidosis requiring medication and those with asymptomatic sarcoidosis or sarcoidosis not requiring medication 10 18 19. Patients with sarcoidosis requiring treatment have higher rates of depressive symptoms and worse quality of life compared with asymptomatic patients6 suggesting those requiring treatment should be evaluated separately.…”

Dissecting the fatigue experience: A scoping review of fatigue definitions, dimensions, and measures in non-oncologic medical conditions

“… Physical Chalder Fatigue Scale Mental Autoimmune Rheumatic Disease ( Ali et al., 2017 ; Huang et al., 2017 ) Cronbach's α ​= ​0.863 ( Huang et al., 2017 ). Physical Chronic Fatigue Syndrome ( Slomko et al., 2020 ) Fatigue Assessment Scale (FAS) Physical Post-Sarcoidosis Fatigue Syndrome ( Gorski et al., 2017 ) FAS total score correlated significantly and positively with age, Beck Depression Inventory (BDI) score (r ​= ​0.726) and Patient Health Questionnaire-9 (PHQ-9) score (r ​= ​0.788). FAS Physical Fatigue scale score correlated with BDI score (r ​= ​0.670) and PHQ-9 (r ​= ​0.768), while FAS Mental Fatigue scale score was positively associated with age and both BDI (r ​= ​0.702) and PHQ-9 (r ​= ​0.705) scores ( Gorski et al., 2017 ).…”

Synthesis of Icariin-Zinc and its Protective Effect on Exercise Fatigue and Reproductive System Related Glands in Male Rats

“…Exercise fatigue is the physiological decline in working ability, activity ability, and range of activity after a strenuous exercise (Narkhede et al, 2016;Górski et al, 2017). The recovery time of exercise fatigue is relatively long and this has an impact on human life and work.…”