Fatigue and psychiatric morbidity among Hodgkin's disease survivors

Fatigue is prevalent among cancer patients, including Hodgkin's disease sur vivors (HDS). Fatigue is poorly understood, and the clinical management is consequently difficult. This ross-sectional study examined how fatigue rela ted to psychiatric morbidity among 457 HDS (aged 19-74 years, 56% males) tr eated during the period 1971-1991. The subjects were mailed a questionnaire including the Fatigue Questionnnaire, the Hospital Anxiety and Depression Scale, and measures of previous psychiatric problems. Fatigue correlated mo derately with anxiety and depression (r = 0.44 and 0.41 respectively). Twen ty-six percent of the HDS had substantial fatigue for 6 months or longer (= cases). They had higher levels of anxiety (mean 7.3 95% CI 6.4-8.1) and de pression (mean 4.5, 95% CI 3.8-5.2) than the non-cases (anxiety: mean 4.3 9 5 % CI 3.9-4.7; depression: mean 2.1, 95% CI 1.8-2.5). Fast psychiatric pro blems were not reported more commonly among the fatigue cases than among th e non-cases. A multiple logistic regression analysis identified age (OR 1.0 4, 95 % CI 1.02-1.06) anxiety (OR 1.2, 95 % CI 1.2-1.3), and no self-report ed psychiatric symptoms during treatment (OR 2.3, 95% CI 1.3-4.2) as predic tors of fatigue caseness. One-half of the fatigue cases among HDS have psyc hological distress that might respond to treatment. Chronic fatigue among H DS is not predicted by previous psychiatric problems (C) U.S. Cancer Pain R elief Committee, 1999.