{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:32:18Z","timestamp":1792096338252,"version":"4.4.0"},"reference-count":40,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[1998,5,13]]},"published-print":{"date-parts":[[1998,11,1]]},"abstract":"<jats:p>\n                  <jats:italic>Background<\/jats:italic>\u2014Fatigue is a frequent and debilitating symptom in patients with primary biliary cirrhosis (PBC).<\/jats:p>\n               <jats:p>\n                  <jats:italic>Aims<\/jats:italic>\u2014To study fatigue in relation to sleep, depression, and liver disease severity.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Methods<\/jats:italic>\u2014Patients with PBC completed validated self report questionnaires measuring fatigue, sleep quality, depression, and functional capacity. Verbally reported fatigue and observer rated measure of depression and ursodeoxycholic acid (UDCA) use were recorded. Liver biochemistry and tests to rule out metabolic causes of fatigue were performed.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Results<\/jats:italic>\u2014Mean age of the 88 patients enrolled was 57 years; 86% were female and mean duration of disease was 6.6 years. Median bilirubin was 13 \u03bcmol\/l (mean 18.6). Verbally reported fatigue (for more than six months) was present in 60 patients (68%). The self rated Fatigue Severity Score (FSS) correlated well with verbally reported fatigue (p=0.0001). The FSS did not correlate with age, duration of disease, serum bilirubin, Mayo Risk Score, or UDCA use, but correlation was seen with sleep quality. Fatigued patients had more sleep problems and higher depression scores than non-fatigued patients. Self rated depression was present in 28% (17\/60) of fatigued compared with 4% (1\/28) of non-fatigued patients.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Conclusions<\/jats:italic>\u2014Long term fatigue affected 68% of the patients with PBC but it was not related to the severity of their liver disease. Poor sleep quality and depression were commonly associated with fatigue.<\/jats:p>","DOI":"10.1136\/gut.43.5.705","type":"journal-article","created":{"date-parts":[[2010,6,30]],"date-time":"2010-06-30T12:46:12Z","timestamp":1277901972000},"page":"705-710","source":"Crossref","is-referenced-by-count":200,"title":["Fatigue in primary biliary cirrhosis"],"prefix":"10.1136","volume":"43","author":[{"given":"K","family":"Cauch-Dudek","sequence":"first","affiliation":[{"name":"aDepartment of Medicine, \n\nbDepartment of Psychiatry, Toronto Hospital, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Abbey","sequence":"additional","affiliation":[{"name":"aDepartment of Medicine, \n\nbDepartment of Psychiatry, Toronto Hospital, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D E","family":"Stewart","sequence":"additional","affiliation":[{"name":"aDepartment of Medicine, \n\nbDepartment of Psychiatry, Toronto Hospital, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E J","family":"Heathcote","sequence":"additional","affiliation":[{"name":"aDepartment of Medicine, \n\nbDepartment of Psychiatry, Toronto Hospital, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1998,11,1]]},"reference":[{"key":"2025090723035340000_43.5.705.1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/13.Supplement_1.S94"},{"key":"2025090723035340000_43.5.705.2","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/hep.1840120116","article-title":"The demography of primary biliary cirrhosis in Ontario, Canada.","volume":"12","author":"Witt-Sullivan","year":"1990","journal-title":"Hepatology"},{"key":"2025090723035340000_43.5.705.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199105303242204"},{"key":"2025090723035340000_43.5.705.4","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(94)90861-3"},{"key":"2025090723035340000_43.5.705.5","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/0016-5085(94)90021-3","article-title":"Urosdeoxycholic acid in the treatment of primary biliary cirrhosis.","volume":"106","author":"Lindor","year":"1994","journal-title":"Gastroenterology"},{"key":"2025090723035340000_43.5.705.6","doi-asserted-by":"crossref","first-page":"174A","DOI":"10.1016\/0270-9139(93)92223-M","article-title":"Detailed histologic grading as a predictor of morbidity and mortality in primary biliary cirrhosis [abstract].","volume":"18","author":"Wanless","year":"1993","journal-title":"Hepatology"},{"key":"2025090723035340000_43.5.705.7","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8613058"},{"key":"2025090723035340000_43.5.705.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70183-5"},{"key":"2025090723035340000_43.5.705.9","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(95)90171-X"},{"key":"2025090723035340000_43.5.705.10","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(93)90104-N"},{"key":"2025090723035340000_43.5.705.11","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"2025090723035340000_43.5.705.12","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"2025090723035340000_43.5.705.13","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"2025090723035340000_43.5.705.14","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"2025090723035340000_43.5.705.15","doi-asserted-by":"publisher","DOI":"10.2466\/pms.1958.8.3.271"},{"key":"2025090723035340000_43.5.705.16","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840100102"},{"key":"2025090723035340000_43.5.705.17","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1981.01780260100011"},{"key":"2025090723035340000_43.5.705.18","unstructured":"Corcoran K Fischer J (1987) Centre for Epidemiologic Studies\u2014Depressed Mood Scale. 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