Multidimensional Fatigue Index Research Articles

The effects of chemotherapy on resting energy expenditure, body composition, and cancer-related fatigue in women with breast cancer: a prospective cohort study

BackgroundBreast cancer (BC) is the most prevalent tumor in women. Improvements in treatment led to declined mortality, resulting in more survivors living with cancer- or therapy-induced comorbidities. In this study, we investigated the impact of neoplasia and chemotherapy on resting energy expenditure (REE) and body composition, in relation to cancer-related fatigue. Inflammatory parameters were checked as possible explanation for changes in REE.MethodsFifty-six women participated: 20 women with BC and 36 healthy controls. Patients were assessed at baseline (T0) and follow-up (T1) after 12 weeks of chemotherapy. Controls were measured once. REE was assessed with indirect calorimetry: body composition (body weight, fat mass, fat-free mass) by air plethysmography. The multidimensional fatigue index (MFI-20) was used to analyze fatigue. Baseline measurements of patients were compared to results of the healthy controls with the independent-samples T-test. The paired-samples T-test investigated the effects of chemotherapy from T0 to T1. A Pearson correlation analysis was conducted between REE, body composition, and fatigue and between REE, body composition, and inflammatory parameters. A linear regression analysis was fitted to estimate the contribution of the significantly correlated parameters. The measured REE at T0 and T1 was compared to the predicted REE to analyze the clinical use of the latter.ResultsAt baseline, patients with BC had significantly higher REE in the absence of differences in body composition. From baseline to T1, REE and body weight did not change. In contrast, fat-free mass declined significantly with concordant increase in fat mass. Fatigue deteriorated significantly. C-reactive protein at baseline predicted the change in energy expenditure. Predicted REE significantly underestimated measured REE.ConclusionsWomen with BC have higher REE in the tumor-bearing state compared to healthy controls. Chemotherapy does not affect REE but alters body composition. Predictive equations are invalid in the BC population. Results of our study can be used to implement personalized nutritional interventions to support energy expenditure and body composition and minimize long-term comorbidities.

Perceived Injustice in Cancer Survivors: Population-Specific Cut-Off Score and Relations with Personal Factors, Symptoms and Quality of Life-A Cross-Sectional Study.

Fatigue and pain are the most common side effects impacting quality of life (QoL) in cancer survivors. Recent insights have shown that perceived injustice (PI) can play a substantial role in these side effects, but research on cancer survivors is scarce. Furthermore, guidelines for recognizing clinically relevant levels of PI in cancer survivors are missing. The aims of this study are to provide a clinically relevant cut-off for PI and to explore relationships between personal characteristics, symptoms, and QoL with PI. This multicenter, cross-sectional study uses the Injustice Experience Questionnaire (IEQ), Numeric Pain Rating Scale (NPRS), Patient-Specific Complaints (PSC), Multidimensional Fatigue Index (MFI), and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 (EORTC-QLQ-C30). A clinical cut-off for PI was identified based on the 75th percentile of IEQ scores. Univariate and multivariate regressions explored the relationship between PI and personal characteristics (sex, age, cancer type, treatment type), symptoms (pain intensity, fatigue), and QoL (daily activity complaints, cancer-related QoL). Cancer survivors (n = 121) were included, and a cut-off of 20 was identified. Significant indirect associations were found between chemotherapy, NPRS, PSC, MFI, and EORTC-QLQ-C30 with PI. In the multivariate model, only MFI (B = 0.205; 95% CI: 0.125-0.018) and age (B = 0.086; 95% CI: -0.191-0.285) maintained a significant association with PI.

Long-term employment status and the association with fatigue in patients with grade II glioma.

ObjectiveTo investigate employment status and return to work in relation to fatigue in patients with World Health Organization (WHO) grade II glioma.DesignExploratory cross-sectional study.SubjectsPatients with grade II glioma, who underwent surgery between 2005 and 2016.MethodsA postal survey was sent in 2019, which included the Short Form-Health and Labour Questionnaire and the Multi-dimensional Fatigue Index. Outcomes of fatigue in subgroups of (not-) return to work were compared using independent t-tests and x2 tests. The association between fatigue and return to work was analysed using multivariable logistic regression.ResultsIn total, 73 patients were included in the study (age at diagnosis 41.0 years (standard deviation (SD) 9.2 years), time post-diagnosis 8.0 years (interquartile range (IQR) 6-11 years). At diagnosis, 61 patients were employed and 32 returned to work during follow-up. The return to work group was significantly younger than the not-return to work group (p = 0.007). The proportion of patients who indicated that the consequences of glioma had affected return to work, in terms of demotion or reduced working hours, was 68.7%. The not-return to work group reported significantly more fatigue in all domains than the return to work group (p < 0.05). Mental fatigue (p = 0.023) and physical fatigue (p = 0.065) were independently associated with return to work, adjusted for age, sex and the use of anti-epileptic drugs.ConclusionLong-term fatigue is associated with return to work in patients with grade II glioma. Patients who were able to work in the long term were less fatigued, younger, more often male, and used less anti-epileptic drugs than the patients who did not return to work.LAY ABSTRACTPatients with glioma have adult brain cancer. These patients are relatively young and are of working age when they develop this disease. Treatment options for glioma have improved over recent years, and patients will survive approximately 5-15 years. Almost all patients are of working age. Because of the increased survival time, patients find it important to continue to participate in society, especially in work. This study examined working patterns in patients with glioma several years after the start of their disease. Fifty-two percent of patients were working 8 years after the diagnosis of glioma. Many patients with brain tumours felt tired (fatigued), both mentally and physically. Patients who were able to work in the long term were less fatigued, younger, more often male, and used less anti-epileptic drugs than the patients who did not return to work.

Results of a RCT assessing saline and xylitol nasal irrigation for CRS and fatigue in Gulf War illness.

ObjectiveTo assess the efficacy of saline nasal irrigation (S‐NI) and xylitol nasal irrigation (X‐NI) for chronic rhinosinusitis in participants with Gulf War illness (GWI).MethodsThis 26 week, 3‐arm (1:1:1) randomized controlled trial examined veterans meeting criteria for GWI with moderate‐to‐severe chronic rhinosinusitis and fatigue symptoms. All participants received standard of care for chronic rhinosinusitis (CRS); additionally, S‐NI or X‐NI participants added twice‐daily NI using 2% saline or 5% xylitol solutions. Outcomes included disease‐specific quality of life (primary; sino‐nasal outcome test [SNOT‐20]; 0‐100 points), overall quality of life (Short‐Form 36), and fatigue (Multidimensional Fatigue Index). Outcome assessors were blind to allocation group. Intention‐to‐treat analysis used repeated measures modeling; statistical significance was evaluated at the two‐sided α level of .05.ResultsRandomization (N = 40) produced three similar groups regarding sex (male, 80%), age (53.8 ± 7.8 years), duration (19.8 ± 7.7 years), and illness severity (48.5 ± 12.7 SNOT‐20 points). Age‐ and gender‐adjusted between‐group comparison showed that X‐NI participants, compared with control, reported improved SNOT‐20 scores at 8 weeks (13.5 points, 95% confidence interval [CI] −27.9 to 0.9) and at 26 weeks (15.4 points, 95% CI −30.1 to −0.6). S‐NI participants improved by 13.4 points (95% CI −28.8, 2.1) at 26 weeks compared with control.The improvement in both NI groups approached minimal clinical important difference compared to control for the SNOT‐20 in the general population. Secondary outcomes were not different between groups. Satisfaction in both irrigation groups was high.ConclusionsThis randomized controlled trial suggests that NI with saline or xylitol improves chronic sinus symptoms among participants with GWI with improvement scores similar to those in the general population.Level of Evidence1b, individual randomized controlled trial.

Treatment of fatigue with physical activity and behavioural change support in vasculitis: study protocol for an open-label randomised controlled feasibility study

IntroductionFatigue is a major cause of morbidity, limiting quality of life, in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The aetiology of fatigue is multifactorial; biological and psychosocial mediators, such...

AB0517 Impaired Sexual Function in Women with Primary SjÖGren's Syndrome

BackgroundPrimary Sjögren's syndrome (pSS) is a chronic and disabling disease, characterized by sicca symptoms of the eyes and mouth as well as fatigue. Besides these well-known symptoms, multiple studies have...

Change in intraindividual variability over time as a key metric for defining performance-based cognitive fatigability

Cognitive fatigability is conventionally quantified as the increase over time in either mean reaction time (RT) or error rate from two or more time periods during sustained performance of a prolonged cognitive task. There is evidence indicating that these mean performance measures may not sufficiently reflect the response characteristics of cognitive fatigue. We hypothesized that changes in intraindividual variability over time would be a more sensitive and ecologically meaningful metric for investigations of fatigability of cognitive performance. To test the hypothesis fifteen young adults were recruited. Trait fatigue perceptions in various domains were assessed with the Multidimensional Fatigue Index (MFI). Behavioral data were then recorded during performance of a three-hour continuous cued Stroop task. Results showed that intraindividual variability, as quantified by the coefficient of variation of RT, increased linearly over the course of three hours and demonstrated a significantly greater effect size than mean RT or accuracy. Change in intraindividual RT variability over time was significantly correlated with relevant subscores of the MFI including reduced activity, reduced motivation and mental fatigue. While change in mean RT over time was also correlated with reduced motivation and mental fatigue, these correlations were significantly smaller than those associated with intraindividual RT variability. RT distribution analysis using an ex-Gaussian model further revealed that change in intraindividual variability over time reflects an increase in the exponential component of variance and may reflect attentional lapses or other breakdowns in cognitive control. These results suggest that intraindividual variability and its change over time provide important metrics for measuring cognitive fatigability and may prove useful for inferring the underlying neuronal mechanisms of both perceptions of fatigue and objective changes in performance.

Carotid body tumors are not associated with an increased risk for sleep-disordered breathing

Tumors in the carotid bodies may interfere with their function as peripheral chemoreceptors. An altered control of ventilation may predispose to sleep-disordered breathing. This study aimed to assess whether patients with unilateral or bilateral carotid body tumors (uCBT or bCBT, respectively) or bilateral CBT resection (bCBR) display sleep-disordered breathing and to evaluate the global contribution of the peripheral chemoreceptor to the hypercapnic ventilatory response. Eight uCBT, eight bCBT, and nine bCBR patients and matched controls underwent polysomnography. The peripheral chemoreflex drive was assessed using euoxic and hyperoxic CO2 rebreathing tests. Daytime sleepiness and fatigue were assessed with the Epworth Sleepiness Scale and the Multidimensional Fatigue Index. All patient groups reported significant fatigue-related complaints, but no differences in excessive daytime sleepiness (EDS) were found. The apnea/hypopnea index (AHI) did not differ significantly between patient groups and controls. Only in bCBT patients, a trend towards a higher AHI was observed, but this did not reach significance (p=0.06). No differences in the peripheral chemoreflex drive were found between patients and controls. Patients with (resection of) CBTs have more complaints of fatigue but are not at risk for EDS. The presence or resection of CBTs is neither associated with an altered peripheral chemoreflex drive nor with sleep-disordered breathing.

Quality of life is decreased in patients with paragangliomas

Germline mutations in succinate dehydrogenase (SDH) genes predispose carriers for developing paragangliomas, and studies on their quality of life (QoL) are scarce. The objectives of this study were to assess QoL in patients with paragangliomas (PGL), to evaluate long-term QoL, and to explore potential differences in QoL between SDH mutation carriers and paraganglioma patients without an SDH mutation. Cross-sectional, case-control study. Tertiary referral center. ONE HUNDRED AND SEVENTY FOUR PARAGANGLIOMA PATIENTS WERE INCLUDED: 25 SDHB, two SDHC, and 122 SDHD mutation carriers and 25 patients without an SDH mutation. They provided 100 peers as control persons. Furthermore, patients were compared with age-adjusted reference populations. QOL WAS ASSESSED USING THREE VALIDATED HEALTH-RELATED QOL QUESTIONNAIRES: the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Index 20, and the Short Form 36. Patients reported a significantly impaired QoL compared with their own controls, mainly on fatigue and physical condition subscales. Compared with age-adjusted literature values, patients had significantly impaired scores on physical, psychological, and social subscales. A decreased QoL was mainly related to paraganglioma-associated complaints. There was no difference in QoL between the various SDH mutation carriers or paraganglioma patients without an SDH mutation. QoL in asymptomatic mutation carriers, i.e. without manifest disease, did not differ from QoL of the general population. Long-term results in 41 patients showed no alteration in QoL besides a reduced level of activity. QoL is decreased in paraganglioma patients but stable when measured over time.

Previous radiotherapy negatively influences quality of life during 4 years of follow‐up in patients cured from acromegaly

Cross-sectional studies have shown impaired quality of life (QoL) in patients in biochemical control of acromegaly. The aim of this study was to assess longitudinal changes in QoL in a homogenous cohort of patients with sustained biochemical control of acromegaly. Prospective follow-up study. QoL was assessed using four health-related QoL questionnaires (HADS, Hospital Anxiety and Depression Scale; MFI-20, Multidimensional Fatigue Index; NHP, Nottingham Health Profile; and SF-36, Short Form-36) and one disease-specific acromegaly quality of life (ACRO-QOL) questionnaire in 82 patients (43 men) with strict biochemical control of acromegaly, aged 56 years (range 29-84 years) at baseline and after 4 years of follow-up. The mean duration of controlled disease was 12 years (range 1-26 years). During follow-up, scores in 5 of 26 QoL subscales significantly worsened: physical and social functioning (SF-36), physical fatigue (MFI-20), and psychological well-being and personal relations (ACRO-QOL). Using linear regression analysis, baseline item scores predicted the follow-up scores, indicating individual stability over time. Previous radiotherapy (n = 27, 33%) negatively influenced several QoL subscales at follow-up: energy, pain and social isolation (NHP), physical fatigue and reduction in activity and motivation (MFI-20), depression and total anxiety and depression scores (HADS) and physical performance (ACRO-QOL). During 4 years of follow-up in patients with long-term biochemical control of ACRO-QOL is subtly, but progressively impaired. Radiotherapy was the predominant indicator of progressive impairment in QoL.

Reduced quality of life in patients with head-and-neck paragangliomas

The objective of this study was to assess the quality of life (QoL) in patients with head-and-neck paragangliomas ('glomus tumors'). We conducted a case-control study. We assessed QoL in 82 patients with head-and-neck paragangliomas using four validated health-related questionnaires: Hospital Anxiety and Depression Scale, Multidimensional Fatigue Index (MFI-20), Short Form-36 (SF-36), and Nottingham Health Profile (NHP). Patient outcomes were compared with controls provided by the patients and with a large age- and sex-adjusted control group. The QoL scores in the paraganglioma patients were significantly reduced in 12 out of the 21 subscales compared with own controls, and in 18 out of the 21 subscales compared with age- and sex-adjusted values derived from the previous studies. In the MFI-20 questionnaire, patients reported more general fatigue, physical fatigue, mental fatigue, and a reduction in activity and motivation. The scores in the NHP showed a difference in energy, emotional reaction, and social isolation. General health perception, pain, and physical functioning were reported to be worse in the paraganglioma patients on the SF-36 scale. Although anxiety and depression did not reveal any significant differences between patients and their own controls, an increased score on both anxiety and depression was seen when compared with the extended control group. Especially, dysphonia contributes to a reduced QoL. QoL is considerably reduced in patients with head-and-neck paragangliomas.

Rationale, design and methods of the ESPRIT study: Energy, Sexual desire and body PropoRtions wIth AndroGel®, Testosterone 1% gel therapy, in hypogonadal men

Hypogonadism is associated with a range of disease states that have significant effects on morbidity and mortality, and also affect quality of life. The ESPRIT study (Energy, Sexual desire and body PropoRtions wIth AndroGel®, Testosterone 1% gel therapy) is a 6-month, multinational, open label, observational study in hypogonadal men being treated with transdermal AndroGel® in usual daily clinical practice; 1,700–2,400 patients will be enrolled in Canada, Germany, Central and Eastern Europe, Russia and the Middle East. The main objective will be to evaluate the effect of AndroGel® on symptoms of hypogonadism and quality of life as assessed by the Aging Males' Symptoms scale. Further objectives include evaluating the effect and time to onset of improvement in erectile dysfunction and libido/sexual desire (International Index of Erectile Function), fatigue (Multi-dimensional Fatigue Index) and body composition (waist circumference, body mass index). Subgroup analyses will be performed: <50 years versus ≥ 50 years; absence versus presence of metabolic syndrome. The safety of AndroGel® will also be assessed. The study population will consist of newly diagnosed hypogonadal men (age ≥ 18 years), in whom testosterone deficiency has been confirmed by clinical features and biochemical tests according to international guidelines, who are currently being prescribed AndroGel® (testosterone 1% gel, starting dose 50 mg testosterone per day).

Quality of Life is Decreased after Treatment for Nonfunctioning Pituitary Macroadenoma

Pituitary gland diseases are, in general, accompanied by an impaired quality of life (QoL). Hypopituitarism is associated with macroadenomas, and QoL is lessened even if there is optimal endocrine replacement. Because most studies of QoL have included both functioning and nonfunctioning tumors, the present study aimed to assess QoL in adults whose nonfunctioning pituitary macroadenomas (NFMAs) were removed by transsphenoidal surgery. The 99 participants, who were in remission following surgery for NFMA and, in some instances, radiotherapy, and whose age averaged 62 years, were compared with 125 age-matched control patients from this and other studies. The four validated health-related questionnaires used were the Hospital Anxiety and Depression Scale (HADS), Multidimensional Fatigue Index (MFI), Nottingham Health Profile (NHP), and Short Form-36 (SF-36). The mean postoperative follow-up was nearly 10 years. All but six of the 99 study patients were pituitary-deficient in at least one axis, and almost half had panhypopituitarism of the anterior pituitary. QoL was impaired in the NFMA group compared with control subjects. All elements of the MFI, which evaluates energy/fatigue, were affected, as were a majority of functions assessed by the NHP and SF-36, which assess general health and well-being. Study patients did less well than controls on all subscales of the HADS. Compared with age-adjusted reference values, deficits were found in social functioning, physical problems, emotional problems, perceived general health, lack of energy, and emotional reactivity. Stepwise univariate linear regression analysis showed age to be an independent predictor of reduced physical ability. The presence of multiple hormonal deficiencies independently predicted role limitations due to physical problems, impaired social functioning, sleep problems, and increased general fatigue. Gonadotropin deficiency predicted increased physical fatigue and reduced activity. Neither radiotherapy nor visual field defects were independent predictors of reduced QoL. Even patients with NFMA who are successfully treated tend to have a considerably impaired quality of life. In the present study, multiple pituitary deficiencies were the strongest predictor of reduced QoL.

Quality of Life Is Decreased after Treatment for Nonfunctioning Pituitary Macroadenoma

Although a reduced quality of life (QoL) has been reported after long-term cure of functioning pituitary adenomas, the effect of successful treatment of nonfunctioning pituitary macroadenoma (NFMA) on QoL has not been fully addressed. Therefore, we evaluated a broad spectrum of QoL parameters in patients successfully treated for NFMA in our center. We conducted a case-control study. We assessed QoL in 99 adult patients (mean age, 61.9 yr; range, 24-86 yr) in remission during long-term follow-up after surgical (n = 99) and additional radiotherapeutic (n = 37) treatment for NFMA by four validated health-related questionnaires (Hospital Anxiety and Depression Scale, Multidimensional Fatigue Index, Nottingham Health Profile, and Short Form-36). Patient outcomes were compared with 125 controls and with age-adjusted reference values derived from the literature. NFMA patients reported significantly impaired QoL in all questionnaires compared with the 125 controls and the age-adjusted reference values. All subscales of fatigue, assessed using the Multidimensional Fatigue Index (general fatigue, physical fatigue, reduction in activity, reduction in motivation, and mental fatigue) were impaired. The scores in the Nottingham Health Profile pointed toward reduced energy and affected emotional reaction. In several subscales of the Short Form-36 (social functioning, role limitations due to physical problems, role limitations due to emotional problems, and general health perception), NFMA patients reported a reduced QoL. QoL is considerably reduced in patients after successful treatment of NFMA.

Gait and gait-related activities and fatigue in Parkinson's disease: What is the relationship?

Purpose. To explore the relationship between gait and gait-related activities and fatigue in Parkinson's disease (PD).Method. Twenty people with idiopathic PD (12 male, 8 female; mean age 64.6 ± 7.96) and 10 age, sex and education matched controls (6 male, 4 female; mean age 63.5 ± 7.03) wore an activity monitor for approximately 24 h, from which the percentage time walking and standing, the number of periods of walking greater than 10 sec were derived. Prior to monitoring, levels of fatigue (Multi-dimensional Fatigue Index, MFI) were evaluated.Results. Activity data related to gait were compared for the waking hours of the day, reflected by the period between 6 am and 10 pm. Overall, PD subjects demonstrated reduced activity compared to controls, however there was no significant difference between PD and controls for the percentage time spent walking (p = 0.149), standing (p = 1.0) or engaged in periods of walking that were greater than 10 sec (p = 0.059). Significantly greater levels of fatigue were experienced by PD subjects in all MFI domains compared to controls (physical p = 0.001; activity p = 0.001; general p = 0.001; mental p = 0.028; motivation p = 0.024). There was no clear association between activity and fatigue in PD subjects.Conclusions. Evidence of increased fatigue is not supported by evidence of significantly decreased levels of activity in PD subjects. The relationship between activity and fatigue therefore remains unclear, highlighting the complex nature of the relationship between these factors. Further work is required to increase our understanding of the impact of fatigue on gait and gait-related activity so that improved management can be explored.

Quality of Life in Patients after Long-Term Biochemical Cure of Cushing’s Disease

To evaluate the long-term impact of cured Cushing's disease on subjective well-being, we assessed quality of life by validated health-related questionnaires in 58 patients cured from Cushing's disease by transsphenoidal surgery (n = 58), some of whom received additional radiotherapy (n = 11) and/or bilateral adrenalectomy (n = 3). The mean duration of remission was 13.4 +/- 6.7 yr (range of 2-25 yr). Patient data were compared with a control group of 98 healthy subjects with the same age and sex distribution and with age-adjusted reference values available from the literature. General perceived well-being, measured by the Nottingham Health Profile and the Short Form, was reduced compared with controls for all subscales (P < 0.001). Patients with Cushing's disease had worse scores on subscales of fatigue Multidimensional Fatigue Index and anxiety and depression (Hospital Anxiety and Depression Scale). Compared with reference values from the literature, quality of life was also reduced in the patients according to all questionnaires and all items, except pain (Short Form), sleep (Nottingham Health Profile), and reduced activity (Multidimensional Fatigue Index). Despite conventional hormone replacement therapy, hypopituitarism was an important independent predictor of reduced quality of life. Patients without hypopituitarism (n = 28) showed reduced scores on physical items but normal scores on mental items compared with controls. In conclusion, despite long-term cure of Cushing's disease, patients experience a considerable decrease in quality of life, with physical and psychosocial impairments, especially in the presence of hypopituitarism.

Decreased Quality of Life in Patients with Acromegaly Despite Long-Term Cure of Growth Hormone Excess

The long-term impact of acromegaly on subjective well-being after treatment of GH excess is unclear. Therefore, we evaluated quality of life by validated questionnaires in a cross-sectional study of 118 successfully treated acromegalic patients. The initial treatment was transsphenoidal surgery in most patients (92%), if necessary followed by radiotherapy or octreotide. All patients were in remission at the time of assessment (GH, <1.9 mug/liter; normal IGF-I for age). General perceived well-being was reduced compared with controls for all subscales (P < 0.001) as measured by the Nottingham Health Profile and the Short Form-36. Acromegalic patients also had lower scores on fatigue (Multidimensional Fatigue Index) and anxiety and depression (Hospital Anxiety and Depression Scale). Radiotherapy was associated with decreased quality of life in all subscales except for the Hospital Anxiety and Depression Scale, and worsened quality of life significantly, according to the fatigue scores. Somatostatin analog treatment was not associated with improved quality of life. Independent predictors of quality of life were age (physical subscales and Nottingham Health Profile), disease duration (social isolation and personal relations), and radiotherapy (physical and fatigue subscales). In conclusion, patients cured after treatment for acromegaly have a persistently decreased quality of life despite long-term biochemical cure of GH excess. Radiotherapy especially is associated with a reduced quality of life.

A psychometric comparison of health-related quality of life measures in chronic liver disease

Four generic [the Sickness Impact Profile (SIP-68), Short-Form Health Survey (SF-36), EuroQol instrument (EQ-5D), COOP/WONCA charts], two domain-specific health-related quality of life measures [the sexuality scale of the HIV Overview Problems Evaluating System (HOPES), Multi-dimensional Fatigue Index (MFI-20)], and a self-developed 12-item symptom index were compared in terms of feasibility, test–retest reliability, internal consistency reliability, construct validity, and known groups validity in patients with chronic liver disease. All instruments could be completed within 10 min and exhibited a good psychometric performance in patients with chronic liver disease. The SF-36 and the MFI-20 performed relatively best in terms of reliability, construct validity, and discriminative ability. The sexuality scale of the HOPES demonstrated a relatively poor performance, as the missing value rate was higher than 5%. Further research is needed into the sensitivity to important clinical changes of the instruments.