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Fatigue and Major Depressive Disorder - A Systematic Review of Etiology, Maintenance, Diagnosis and Treatment

Sundermann, J. H. (2016) Fatigue and Major Depressive Disorder - A Systematic Review of Etiology, Maintenance, Diagnosis and Treatment.

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Abstract:Background and Objectives. Fatigue belongs to the most common experiences of human life but it often co-occurs with psychopathology as well, especially in mood disorders such as Major Depressive Disorder (MDD). Although, fatigue is often reported as symptom in MDD, rated by patients as restricting and harming, the presumably interdependent relation between both syndromes still remains unclear. This review seeks to deliver a comprehensive overview about the relationship between fatigue and MDD regarding etiological processes, maintaining factors, relevance of diagnosis criteria and treatment concepts. Methods. A systematic literature review was conducted in 2016. The authors used differentiated search terms to bear reference to the multidimensionality of fatigue combined with the key indexing term Major Depressive Disorder and distinct search terms to answer four research questions with regard to etiology, maintenance, diagnosis and treatment. Results. In total, 45 studies were included in the review, with various study designs, study populations and sample sizes. Firstly, a strong relationship between fatigue and MDD was found indicating that fatigue serves as a predictor of MDD and its persistence, whereby related pathophysiological processes are involved. Secondly, fatigue may reinforce the maintenance of MDD by building on a vicious cycle and enhanced by subsequent factors, due to side effects of medication or sleep disturbances. Thirdly, according to the DSM-IV fatigue-related symptoms did not fulfil alone the requirements for an MDD diagnosis, however, the overlap of symptoms of fatigue and MDD cannot be ignored. Fourthly, fatigue-related symptoms were treated with antidepressants differing in effectiveness. In addition, CBT and complementary strategies showed promising treatment results for the improvement of fatigue. Conclusion. The relationship between fatigue and MDD is a complex and many-layered one influenced by various processes. Further, the overlap of symptoms and etiological processes, and maintaining factors of fatigue in MDD may encourage the discussion about the relevance of fatigue-related symptoms in the DSM-IV. At last, pharmacological treatment needs to be symptom-specific and requires the awareness for impeding side effects of medication.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:http://purl.utwente.nl/essays/71237
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