Treating Depression May Affect Fatigue, Pain in Patients with MS

A study observed that early treatment of depression in patients with multiple sclerosis (MS) may be correlated with improvements in fatigue and pain.

“Depression, fatigue, and pain commonly co-occur in MS and are positively associated with one another. However, it is unclear whether treatment-related improvement in one of these symptoms is associated with improvements in the other two symptoms,” the researchers explained.

They conducted a secondary analysis of a randomized, controlled trial that evaluated improvements in depressive symptoms, fatigue, and pain interference. A total of 154 adults (86% were female) with MS who had chronic pain, chronic fatigue, and/or moderate depressive symptoms were randomized to an eight-week, telephone-delivered intervention of either self-management (n=69) or education (n=85). The present analysis combined both treatment groups. The main outcomes of depressive symptoms, fatigue impact, and pain interference were measured using the Patient Health Questionnaire-9, Modified Fatigue Impact Scale, and Brief Pain Inventory, respectively. The study authors evaluated how pre-to-mid intervention improvement in one symptom was correlated with pre-to-post improvement in the other two symptoms.

A relationship was observed between early reduction in depressive symptoms and reductions in both pain interference and fatigue impact (P<0.01). Early reduction in fatigue impact was predictive of an overall reduction in depressive symptom severity (P=0.04) but was not associated with reductions in pain interference. Early reduction in pain interference did not result in reductions in fatigue impact or depressive symptoms.

“These findings suggest the potential importance of reducing depressive symptoms to overall improvement in fatigue and pain interference in persons with MS,” the study authors concluded.