Impact of fatigue on the quality of life of patients with primary biliary cirrhosis

OBJECTIVE: Fatigue is a frustrating symptom frequently reported by patients with primary biliary cirrhosis (PBC), but it is still poorly understood an d not well evaluated. Our aim was to determine its importance and its impac t on the quality of life and mental health status of patients with PBC. METHODS: Patients with PBC (103 women and 13 men with a mean age of 52.6 yr ) completed self-report questionnaires to evaluate the impact of fatigue on their quality of life (Fatigue Impact Scale, FIS), the perception of their own mental health (Symptom Check list-90-R, SCL), and depression (Beck Dep ression Inventory, BDI). A cohort of age-matched healthy blood donors serve d as controls. RESULTS: Fatigue was present in 99 patients (85.3%) and was the worst or on e of the worst symptoms in about half of them. In PBC patients, the mean FI S and SCL indexes were significantly increased, compared to healthy control s (1.49 +/- 1.11 vs 0.6 +/- 0.6 and 0.72 +/- 0.55 vs 0.36 +/- 0.35, respect ively). Unexpectedly, 52 patients (44.8%) could be classified as having dep ression (BDI score >10). Significant correlations were found between the FI S and SCL indexes, between the FIS index and the BDI score, as well as betw een the BDI score and the SCL index. Finally, fatigue was not related to th e disease severity parameters, that is, clinical, biochemical, metabolic, a nd pathological. CONCLUSIONS: Fatigue is a frequent and disabling complaint that impairs the quality of Life of PBC patients and their perception of their own mental h ealth, which may be associated with an unexpected depressive condition. In addition, the FIS questionnaire can be considered as a useful tool to asses s fatigue in PBC patients and may be used in the evaluation of specific tre atments aimed at reducing this complaint in such patients. (Am J Gastroente rol 2000;95. 760-767. (C) 2000 by Am. Coil. of Gastroenterology).