Fatigue is a common and disabling problem in inflammatory bowel disease. We sought to explore the possible determinants of inflammatory bowel disease-associated fatigue including demographic, psychological and disease variables.
Surveys were distributed to 100 patients undergoing infliximab infusion for inflammatory bowel disease in an infusion lounge, assessing attachment style (Experiences in Close Relationships Revised scale), fatigue (Functional Assessment of Chronic Illness Therapy Fatigue - Fatigue Subscore), and depression and anxiety (Hospital Anxiety and Depression Scale). Disease severity was assessed via file review through an independent gastroenterologist rating (Harvey-Bradshaw Index).
There were 67 responses. Depression, as measured by the Hospital Anxiety and Depression Scale, was found to be highly correlated with fatigue (Functional Assessment of Chronic Illness Therapy Fatigue - Fatigue Subscore). Anxiety, insecure attachment, disease severity and female gender were moderately correlated with fatigue. In a hierarchical regression model, depression and female gender emerged as significant predictors of variance in fatigue scores.
Depression was the strongest predictor of variance in fatigue scores. Gender as a cause of fatigue in inflammatory bowel disease requires further exploration. Attachment style, however, may still help clinicians to conceptualise help-seeking behaviour and clinician-patient relationships in medically unexplained symptoms.