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The Brief Fatigue Syndrome Scale: Validation and Utilization in Fatigue Recovery Studies

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Abstract

Medically, nonexplained fatigue is a significant clinical and public health concern. However, the construct fatigue is not easily defined, and this is reflected in the large number of different scales used to measure fatigue. In this chapter, we define fatigue using the sustained stress activation theory. It is proposed that sustained stress, with a lack of sufficient recovery periods, is characterized by a decline in the ability to concentrate, be energetic, and sleep. Based on this definition, the brief fatigue syndrome scale (BFSS) was created using visual analogue scales (VAS) to rate self-assessed energy, ability to concentrate, and quality of sleep. The BFSS consisted of one factor, with a Cronbach’s α of >0.70. The validity and sensitivity of the scale was assessed by following a group of fatigued patients undergoing a 1-year lifestyle recovery program. In addition, a reference group of healthy controls was followed over the same period. Both groups responded regularly to a survey containing the BFSS. Blood samples were also collected during the first 6 months. The BFSS scores decreased significantly as the clinical conditions of the fatigued participants improved. Furthermore, self-rated mental energy, assessed by a separate and validated five-item Likert-type scale, improved with decreasing fatigue. Participants scoring above the proposed cut-off point of 8 for depression on the hospital depression and anxiety scale had significantly higher BFSS scores. BFSS scores were also higher among subjects scoring in the burn-out range on the Shirom-Melamed scale. Decreased fatigue over time was related to improved/ increased serum levels of testosterone. It is suggested that the cut-off point for fatigue vs. nonfatigue should be set at 40%. The BFSS is suggested as a valid and quick instrument to assess fatigue.

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Authors and Affiliations

  1. Section for Social Medicine, Department of Public Health, Uppsala University, Uppsala Science Park, SE-751 05, Uppsala, Sweden

    Bengt B. Arnetz

  2. Division of Occupational and Environmental Health, Department of Family Medicine and Public Health Sciences, Wayne State University, 3800 Woodward Ave, Suite 808, Detroit, MI, 48201, USA

    Bengt B. Arnetz

  3. Center for Environmental Health and Stress Disorders (CEOS), Uppsala Academic Hospital, SE-751 85, Uppsala, Sweden

    Bengt B. Arnetz & Lena Frenzel

  4. Department of Public Health Sciences, Division of Psychosocial Factors and Health, and Institute for Psychosocial Medicine (IPM), Karolinska Institutet, PO Box 220, SE-171 77, Stockholm, Sweden

    Torbjörn Åkerstedt

  5. Research Group for Behavioral Medicine and Health Psychology, Department of Social Sciences (Psychology Section), Mid-Sweden University at Östersund, SE-83125, Östersund, Sweden

    Jan Lisspers

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Editor information

Editors and Affiliations

  1. Molecular Imaging Research Program, RIKEN, 6-7-3 Minatojima-minamimachi, Chuo-ku, Kobe, 650-0047, Japan

    Yasuyoshi Watanabe M.D., Ph.D. (Program Director and Professor) (Program Director and Professor)

  2. Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Yasuyoshi Watanabe M.D., Ph.D. (Program Director and Professor) (Program Director and Professor)

  3. Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska, University Hospital Huddinge, SE-141 86, Stockholm, Sweden

    Birgitta Evengård M.D. (Professor, Senior Consultant) (Professor, Senior Consultant)

  4. Division of Infectious Diseases, Department of Clinical Microbiology, Umeå University, SE-901 85, Umeå, Sweden

    Birgitta Evengård M.D. (Professor, Senior Consultant) (Professor, Senior Consultant)

  5. New Jersey Medical School, University of Medicine and Dentistry, Newark, NJ, 07103, USA

    Benjamin H. Natelson M.D. (Professor of Neurosciences) (Professor of Neurosciences)

  6. Center for Community Research, DePaul University, 990 West Fullerton, Suite 3100, Chicago, IL, 60614, USA

    Leonard A. Jason Ph.D. (Professor and Director) (Professor and Director)

  7. Department of Health Science, Faculty of Health Science for Welfare, Kansai University of Welfare Sciences, 3-11-1 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan

    Hirohiko Kuratsune M.D., Ph.D. (Professor) (Professor)

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© 2008 Springer

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Arnetz, B.B., Frenzel, L., Åkerstedt, T., Lisspers, J. (2008). The Brief Fatigue Syndrome Scale: Validation and Utilization in Fatigue Recovery Studies. In: Watanabe, Y., Evengård, B., Natelson, B.H., Jason, L.A., Kuratsune, H. (eds) Fatigue Science for Human Health. Springer, Tokyo. https://doi.org/10.1007/978-4-431-73464-2_5

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  • DOI: https://doi.org/10.1007/978-4-431-73464-2_5

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-73463-5

  • Online ISBN: 978-4-431-73464-2

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