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 and not well evaluated. Our aim was to determine its importance and its impact 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 Depression Inventory, BDI). A cohort of age-matched healthy blood donors served as controls. RESULTS: Fatigue was present in 99 patients (85.3%) and was the worst or one of the worst symptoms in about half of them. In PBC patients, the mean FIS and SCL indexes were significantly increased, compared to healthy controls (1.49 +/- 1.11 vs 0.6 +/- 0.6 and 0.72 +/- 0.55 vs 0.36 +/- 0.35, respectively). Unexpectedly, 52 patients (44.8%) could be classified as having depression (BDI score >10). Significant correlations were found between the FIS and SCL indexes, between the FIS index and the BDI score, as well as between the BDI score and the SCL index. Finally, fatigue was not related to the disease severity parameters, that is, clinical, biochemical, metabolic, and 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 health, which may be associated with an unexpected depressive condition. In addition, the FIS questionnaire can be considered as a useful tool to assess fatigue in PBC patients and may be used in the evaluation of specific treatments aimed at reducing this complaint in such patients. (Am J Gastroenterol 2000;95. 760-767. (C) 2000 by Am. Coil. of Gastroenterology).