Fatigue and depression predict health-related quality of life in patients with pediatric-onset multiple sclerosis

Background: Fatigue, depression and loss in health-related quality of life (HRQoL) have been reported to occur in a substantial amount of patients with pediatric-onset MS (POMS). This study aims to evaluate depression, fatigue and HRQoL and its relationship in a cohort of patients with POMS and matched healthy controls (HCs). Methods: In a multicenter cross-sectional study, Beck Depression Inventory II, Depressionstest für Kinder, the Pediatric Quality of Life Inventory (PedsQL™) 4.0 Generic Core Scale and the PedsQL™ Multidimensional Fatique Scale were performed. Results: In a cohort of 106 patients with POMS and 210 matched HCs, patients were significantly more often depressed (21.7% vs. 11.4%, p = 0.014) experienced greater fatigue (40.6% vs. 17.3%, p < 0.001) and a greater loss of HRQoL (43.4% vs. 15%, p < 0.001) than controls. Depression predicted 51.8% of variance of fatigue. Fatigue was also predicted by female gender. Loss of HRQoL was predicted by EDSS, depression and fatigue. Depression and fatigue together explained 67.7% of variance of HRQoL. Conclusion: Patients with POMS are at a significant increased risk for depression, fatigue and loss of HRQoL. Furthermore, fatigue and depression significantly predict reduced HRQoL in POMS, suggesting that testing for these symptoms and early therapy is of utmost importance in all patients with POMS.