Frequency and natural history of fatigue after stroke: A systematic review of longitudinal studies

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• 作者：Fiona Duncan^a ; ^{fduncan1@staffmail.ed.ac.uk} ; Simiao Wu^b ; ¹ ; Gillian E. Mead^a ; ² ; ^{gillian.e.mead@ed.ac.uk}
• 关键词：Post-stroke fatigue ; Rehabilitation ; Chronic disease ; Depression
• 刊名：Journal of Psychosomatic Research
• 出版年：2012
• 期刊代码：170_00223999
• 类别：med
• 出版时间：July, 2012
• 卷：73
• 期：1
• 页码：18-27
• 文件大小：298 K

摘要

Background

Fatigue is a common and distressing symptom after stroke. Stroke survivors and health professionals need to know whether fatigue is likely to improve, or get worse over time; and whether there is a temporal association with depression or anxiety, which might provide a target for treatment,

Aims and objectives

To systematically review all longitudinal observational studies which have assessed fatigue on at least two separate time points after stroke onset to determine its frequency, natural history and temporal relationship with anxiety and/or depression.

Method

We systematically searched MEDLINE, EMBASE, CINAHL and PsychInfo using the keywords 鈥渇atigue鈥?and 鈥渟troke鈥?and their associated terms or synonyms. Data were extracted regarding time points after stroke where fatigue was assessed, frequency of fatigue at each time point and any reported associations with anxiety and/or depression.

Results

101 full texts were retrieved after scrutinising the titles and abstracts. Nine fulfilled our inclusion criteria. Fatigue was assessed at a variety of time points after stroke (from admission鈥攖o 36 months). The frequency of fatigue ranged from 35%-92%at the first time point. Frequency of fatigue declined across time points in seven of the studies (n = 764) and increased in two studies (n = 195). Three papers found significant associations between fatigue and mood at the same time point. The single study investigating temporal associations between fatigue and mood disorders reported that depression predicted subsequent fatigue.

Conclusions

Fatigue is present soon after stroke onset and remains common in the longer term. There is little evidence regarding the temporal relationship between fatigue and mood: this is an area where further research is needed.