4.3 Article

Fatigue as a Cause, Not a Consequence of Depression and Daytime Sleepiness: A Cross-Lagged Analysis

期刊

JOURNAL OF HEAD TRAUMA REHABILITATION
卷 29, 期 5, 页码 427-431

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HTR.0b013e31829ddd08

关键词

cross-lagged analysis; daytime sleepiness; depression; fatigue; head injury; longitudinal study; traumatic brain injury

资金

  1. National Health and Medical Research Council (Australia) [334002]
  2. Monash University, Melbourne

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Objectives: To examine the temporal relation between fatigue, depression, and daytime sleepiness after traumatic brain injury. Fatigue is a frequent and disabling consequence of traumatic brain injury (TBI). However, it is unclear whether fatigue is a primary consequence of the structural brain injury or a secondary consequence of injury-related sequelae such as depression and daytime sleepiness. Participants: Eighty-eight adults with complicated mild-severe TBI (69% male). Main Measures: Fatigue Severity Scale; depression subscale of the Hospital Anxiety and Depression Scale; Epworth Sleepiness scale at baseline and 6-month follow-up. Results: A cross-lagged path analysis computed within a structural equation modeling framework revealed that fatigue was predictive of depression (beta = .20, P < .05) and sleepiness (beta = .25, P < .05). However, depression and sleepiness did not predict fatigue (P > .05). Conclusions: The results support the view of fatigue after TBI as primary fatigue-that is, a consequence of the structural brain injury rather than a secondary consequence of depression or daytime sleepiness. A rehabilitation approach that assists individuals with brain injury in learning to cope with their neuropsychological and physical limitations in everyday life might attenuate their experience with fatigue.

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