{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:13:01Z","timestamp":1789665181542,"version":"4.0.1"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Genetics"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Marfan syndrome (MFS) is a connective tissue disorder affecting the cardiovascular, ocular, and skeletal system, which may be accompanied by psychological features. This study aimed to determine the prevalence of fatigue, anxiety, and symptoms of depression in MFS patients, and to assess the degree to which sociodemographic and clinical variables are associated with fatigue and psychological aspects. The prevalence of fatigue, anxiety, and symptoms of depression were assessed in two cohorts of MFS patients and compared with healthy controls. The checklist individual strength (CIS), and hospital anxiety and depression scale (HADS) questionnaires were utilized. Medical status was assessed (family history of MFS, aortic root dilatation &gt;40\u2009mm, previous aortic surgery, aortic dissection, chronic pain, skeletal involvement, and scoliosis). Severe fatigue was experienced by 37% of the total MFS cohort (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u2009155). MFS patients scored significantly higher on the CIS questionnaire, concerning severe fatigue, as compared with the general Dutch population (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u20090.0001). There were no differences in HADS anxiety or depression scores. In older MFS patients, with a more severe cardiovascular phenotype, chronic pain, and a higher unemployment rate, significantly more symptoms of depression were observed, when compared with the general population (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u20090.027) or compared with younger MFS patients (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u20090.026). Multivariate analysis, showed that anxiety was associated with chronic pain (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u20090.022) and symptoms of depression with unemployment (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u20090.024). MFS patients report significantly more severe fatigue as compared with the general population. Since the cause of fatigue is unclear, more research may be needed. Psychological intervention, for example, cognitive behavioral therapy, may contribute to a reduction in psychological symptoms.\n                  <\/jats:p>","DOI":"10.1111\/cge.14211","type":"journal-article","created":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T23:09:30Z","timestamp":1662332970000},"page":"404-413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A cross\u2010sectional study on fatigue, anxiety, and symptoms of depression and their relation with medical status in adult patients with\n                    <scp>M<\/scp>\n                    arfan syndrome. Psychological consequences in\n                    <scp>M<\/scp>\n                    arfan syndrome"],"prefix":"10.1111","volume":"102","author":[{"given":"Mitzi M.","family":"van Andel","sequence":"first","affiliation":[{"name":"Department of Cardiology Amsterdam UMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Graaumans","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Groenink","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC  Amsterdam The Netherlands"},{"name":"Department of Radiology Amsterdam UMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aeilko H.","family":"Zwinderman","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Biostatistics and Bioinformatics Amsterdam UMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland R. J.","family":"van Kimmenade","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Radboud University Hospital  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur J. H. A.","family":"Scholte","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten P.","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Dickinson","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Knoop","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos A.","family":"Bosch","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J. M.","family":"Mulder","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"de Waard","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Amsterdam UMC, Amsterdam Cardiovascular Sciences University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor","family":"Bennebroek Evertsz'","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology Amsterdam UMC, University of Amsterdam  Amsterdam The 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