Article

OBJECTIVES: To examine the temporal relation between fatigue, depression, and
daytime sleepiness after traumatic brain injury. Fatigue is a frequent and
disabling consequence of traumatic brain injury (TBI). However, it is unclear
whether fatigue is a primary consequence of the structural brain injury or a
secondary consequence of injury-related sequelae such as depression and daytime
sleepiness. PARTICIPANTS: Eighty-eight adults with complicated mild-severe TBI
(69% male). MAIN MEASURES: Fatigue Severity Scale; depression subscale of the
Hospital Anxiety and Depression Scale; Epworth Sleepiness scale at baseline and
6-month follow-up. RESULTS: A cross-lagged path analysis computed within a
structural equation modeling framework revealed that fatigue was predictive of
depression (beta = .20, P < .05) and sleepiness (beta = .25, P < .05). However,
depression and sleepiness did not predict fatigue (P > .05). CONCLUSIONS: The
results support the view of fatigue after TBI as "primary fatigue"-that is, a
consequence of the structural brain injury rather than a secondary consequence of
depression or daytime sleepiness. A rehabilitation approach that assists
individuals with brain injury in learning to cope with their neuropsychological
and physical limitations in everyday life might attenuate their experience with
fatigue.

Langue : ANGLAIS