Crohn's disease and fatigue: Constancy and co-variations of activity of the disease, depression, anxiety and subjective quality of life

Fatigue in Crohn's disease (CD) is considered as a consequence of the disease and its treatment. If research showed the impact of the activity of the disease on vitality, patients can express fatigue even if the disease is inactive. Sleep disturbances are now considered in inflammatory bowel disease (IBD) and they could be involved in fatigue. It is well-known that depression and anxiety occur in IBD: They involve sleep disturbances and asthenia. But neither factors have been assessed simultaneously from a longitudinal perspective. Fifty-two patients participated in this study. Fatigue (MFI), depression (HAD-D), anxiety (HAD-A), sleep disturbances (ISI, IQPS), subjective quality of life (Mos-SF36) and activity of the disease (CDAI) were assessed twice with a one-year interval. Results showed constancy in fatigue and the mental health state. Moreover, if depression, anxiety, quality of life, and fatigue followed the same course of activity of the disease only during one visit, CDAI did not correlate with these dimensions between visits. CDAI only prognosticated insomnia. These results suggest that fatigue and poor quality of life may be primarily linked to depression in a secondary context of CD.