The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus
Abstract
Fatigue is a prominent disabling symptom in a variety of medical and neurologic disorders. To facilitate research in this area, we developed a fatigue severity scale, subjected it to tests of internal consistency and validity, and used it to compare fatigue in two chronic conditions: systemic lupus erythematosus and multiple sclerosis. Administration of the fatigue severity scale to 25 patients with multiple sclerosis, 29 patients with systemic lupus erythematosus, and 20 healthy adults revealed that the fatigue severity scale was internally consistent, correlated well with visual analogue measures, clearly differentiated controls from patients, and could detect clinically predicted changes in fatigue over time. Fatigue had a greater deleterious impact on daily living in patients with multiple sclerosis and systemic lupus erythematosus compared with controls. The results further showed that fatigue was largely independent of self-reported depressive symptoms and that several characteristics could differentiate fatigue that accompanies multiple sclerosis from fatigue that accompanies systemic lupus erythematosus. This study demonstrates (1) the clinical and research applications of a scale that measures fatigue severity and (2) helps to identify features that distinguish fatigue between two chronic medical disorders.
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The FSS is a validated 9-item measure; average scores of ≥4 are suggestive of fatigue.
“Fatigue severity was assessed with the Fatigue Severity Scale (FSS)40, a validated 9-item measure; average scores of ≥4 are suggestive of fatigue40–44.”
From Ecological momentary assessment of pain, fatigue, depressive, and cognitive symptoms reveals significant daily variability in multiple sclerosis (2017) · cites this paper as [40]
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Marques, M. M., De Gucht, V., Gouveia, M. J., Leal, I., & Maes, S. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.05.009 · Cited by 50 · see citing works
Carletto, S., Tesio, V., Borghi, M., Francone, D., Scavelli, F., Bertino, G., Malucchi, S., Bertolotto, A., Oliva, F., Torta, R., et al. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.02083 · Cited by 49 · see citing works
Validation Study for the Korean Version of Fear of Cancer Recurrence Inventory
Shin, J., Goo, A., Ko, H., Kim, J.-H., Lim, S.-U., Lee, H.-K., Simard, S., & Song, Y.-M. (2017) · Journal of Korean Medical Science · doi:10.3346/jkms.2017.32.11.1792 · Cited by 47 · see citing works
Know thyself: Exploring interoceptive sensitivity in Parkinson's disease
Ricciardi, L., Ferrazzano, G., Demartini, B., Morgante, F., Erro, R., Ganos, C., Bhatia, K. P., Berardelli, A., & Edwards, M. (2016) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2016.03.019 · Cited by 46 · see citing works
Faria, A. L., Latorre, J., Silva Cameirão, M., Bermúdez i Badia, S., & Llorens, R. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1233346 · Cited by 46 · see citing works
A Pilot Study Assessing Adherence to Auto-Bilevel Following a Poor Initial Encounter with CPAP
Powell, E. D., Gay, P. C., Ojile, J. M., Litinski, M., & Malhotra, A. (2012) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.1658 · Cited by 46 · see citing works
Gill, S., Santo, J., Blair, M., & Morrow, S. A. (2019) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/appi.neuropsych.18010011 · Cited by 46 · see citing works
- Authors
- Krupp, L. B.
- Affiliations
- State University of New York (US)
- Corresponding author
- Krupp, Lauren B.
- ORCID
- Krupp, Lauren B.
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 1989-10-01
- Volume
- 46
- Issue
- 10
- Pages
- 1121
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2114242035
- Cited by
- 6,172
- References
- 1
- Citations by year
- 2026: 359 · 2025: 425 · 2024: 403 · 2023: 369 · 2022: 426 · 2021: 418 · 2020: 361 · 2019: 343 · 2018: 275 · 2017: 235 · 2016: 254 · 2015: 262 · 2014: 243 · 2013: 240 · 2012: 193
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- Fatigue Severity Scale, fatigue severity, multiple sclerosis, systemic lupus erythematosus, chronic fatigue, scale development, internal consistency, construct validity, depressive symptoms, impact on daily life, visual analogue scale
- MeSH terms
- Adult, Disability Evaluation, Fatigue, Humans, Lupus Erythematosus, Systemic, Multiple Sclerosis, Neurologic Examination, Severity of Illness Index
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