The Dimensionality of the Multidimensional Fatigue Inventory (MFI-20) Derived From Healthy Adults and Patient Subpopulations: A Challenge for Clinicians.

INTRODUCTION: Fatigue is associated with various diseases of different origins extending from immune disorders to cancer. The purpose of this study was to explore the psychometric properties/dimensionality of the Multidimensional Fatigue Inventory (MFI-20) questionnaire in samples of healthy adults and patient subgroups in Greece. METHODS: This was a multicenter cross-sectional study that included 80 women with breast cancer, 108 patients with multiple sclerosis (MS), 100 people with thalassemia diagnosis, and 185 healthy adults, aged 18-45 years. All patients were adults. Patients were recruited from a breast surgery clinic, a neurological clinic, and a thalassemia unit, while healthy adults were recruited from the University of West Attica students and personnel. The MFI-20, the modified fatigue impact scale (MFIS), the fatigue severity scale (FSS), and the Hamilton anxiety-depression scale (HANDS) were used. Internal consistency, repeatability, test-retest reliability, construct, and convergent validity were investigated. RESULTS: MFI-20 exhibited excellent reliability properties (internal consistency: Cronbach's alpha MFI-20 subscales ranged from 0.83 to 0.94; repeatability: Pearson's r = 0.335 [p < 0.001]). Significant correlations were found between MFI-20 and MFIS: Pearson's r = 0.870, FSS: Pearson's r = 0.582 - 0.335, and HANDS: Pearson's r = 0.734 - 0.442 (all p-values < 0.0001) on all subsamples. However, its dimensionality is questionable depending on the subpopulation tested, and the one-dimension perspective is possible. MS patients exhibited the highest total score (55.26 ± 16.53), while thalassemia patients exhibited the lowest score (45.09 ± 13.54). In all subscales, thalassemia patients differed statistically significantly from the MS patients (p < 0.01), while in the reduced activity subscale, thalassemia patients differed significantly from all other groups (p < 0.01). CONCLUSIONS: As strict fatigue subscale classification is questionable, the use of MFI-20 total score is suggested for the assessment of fatigue in clinical populations. As MFI-20 is a very useful research tool for studying fatigue, the use of the total and/or partial scores depends on the clinical population. Total score instead of (or additionally) partial scores is suggested in clinical practice.

Smoking in health science students with asthma.

It is expected that asthmatic students in a health science department would avoid the hazards of cigarette smoking due to the knowledge they gain through their studies. Surprisingly, health science students with asthma had a higher prevalence of smoking than their healthy colleagues.

Depression and pulmonary function in outpatients with asthma.

The purpose of this study was to examine the relation between depression, anxiety and pulmonary function in asthmatics. Thirty-eight adult asthmatic patients underwent psychometric evaluation with the DSSI/sAD questionnaire, filled in an asthma questionnaire and underwent spirometry. The majority of patients suffered from mild-persistent asthma. Twenty-six reported symptoms of anxiety and 25 reported symptoms of depression. A statistically significant reduction in FEV1 and FEV1/FVC values was observed in asthmatic patients with symptoms of depression. The mean value of FEV1 was 81.84(+/-20.83) in patients without symptoms and 63.73(+/-17.99) in patients with symptoms of depression. The mean values of FEV1/FVC were 0.85(+/-0.11) and 0.75(+/-0.10), respectively. These findings indicate a high frequency of depression and anxiety in adult asthmatic patients. A biological linkage between depression and impaired pulmonary function is proposed.

Left-handedness in asthmatic children.

Left-handedness has been associated with asthma and allergic disorders. The Geschwind-Behan-Galaburda (GBG) hypothesis could explain this association. In view of previous findings, we investigated the distribution of laterality scores among asthmatic children and controls aged 4-8 years old. Seventy families with asthmatic children were administered the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire and the Edinburgh Left-handedness Inventory. A sample of 70 families with non-asthmatic, healthy children was used as controls. The majority of children had mild asthma. Ambidexterity was the main feature in the asthmatic children. A statistically significant difference in the laterality quotient (LQ) distribution was found in the group of asthmatic children with allergic rhinitis (LQ mean value in the asthmatic children with allergic rhinitis: 42.85 vs. 79.50 in the rest of the asthmatic children). These results suggest that there is a tendency towards left-handedness in asthmatic children and lend support to the GBG hypothesis.