Is fatigue a disease-specific or generic symptom in chronic medical conditions?

Juliane Menting, Cees J. Tack, Gijs Bleijenberg, Rogier Donders, Hal A. Droogleever Fortuyn, Jaap Fransen, Martine M. Goedendorp, Joke S. Kalkman, Riet Strik-Albers, Nens van Alfen, Sieberen P. van der Werf, Nicol C. Voermans, Baziel G. van Engelen, Hans Knoop

Research output: Contribution to journalArticleAcademicpeer-review


Objective: Severe fatigue is highly prevalent in various chronic diseases. Disease-specific fatigue models have been developed, but it is possible that fatigue-related factors in these models are similar across diseases. The purpose of the current study was to determine the amount of variance in fatigue severity explained by: (a) the specific disease, (b) factors associated with fatigue across different chronic diseases (transdiagnostic factors), and (c) the interactions between these factors and specific diseases. Method: Data from 15 studies that included 1696 patients with common chronic diseases and disorders that cause long-term disabilities were analyzed. Linear regression analysis with the generalized least-squares technique was used to determine fatigue-related factors associated with fatigue severity, that is, demographic variables, health-related symptoms and psychosocial variables. Results: Type of chronic disease explained 11% of the variance noted in fatigue severity. The explained variance increased to 55% when the transdiagnostic factors were added to the model. These factors were female sex, age, motivational and concentration problems, pain, sleep disturbances, physical functioning, reduced activity and lower self-efficacy concerning fatigue. The predicted variance increased to 61% when interaction terms were added. Analysis of the interactions revealed that the relationship between fatigue severity and relevant predictors mainly differed in strength, not in direction. Conclusions: Fatigue severity can largely be explained by transdiagnostic factors; the associations vary between chronic diseases in strength and significance. This suggests that severely fatigued patients with different chronic diseases can probably benefit from a transdiagnostic fatigue-approach which focuses on individual patient needs rather than a specific disease.
Original languageEnglish
Pages (from-to)530-543
JournalHealth Psychology
Issue number6
Publication statusPublished - 2018

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