Abstract
Background and Objectives: Fatigue, despite being one of the most common and disabling symptoms in multiple sclerosis (MS), is far from being fully understood. The aim of the present study was to explore the association between fatigue and resilience, illness perception, and mindfulness traits, accounting for the impact of anxiety and depression in young adults with MS (YawMS). Methods: For this cross-sectional exploratory analysis, the following inclusion criteria applied: age 18-45 years, MS diagnosis, Expanded Disability Status Scale <3.5. Fifty-one YAwMS (mean age: 33.5 ± 6.7 years; 76% women, 24% men; 96% relapsing-remitting MS) completed validated questionnaires. Student's t-tests and Spearman correlations, with partial correlations controlling for anxiety and depression, were performed. Finally, a preliminary multivariate model (seemingly unrelated regression) was applied. Results: Despite low disability levels, 69% experienced moderate to severe fatigue (average fatigue score 61.9 ± 17.9). Higher total fatigue was associated with negative illness perception, particularly regarding identity and consequences (p = 0.66 and p = 0.67, respectively), and lower levels of non-judgment and non-reactivity (p = -0.48 and p = -0.54, respectively), and these relationships persisted after controlling for anxiety and depression. Although resilience was negatively correlated with fatigue, its impact was not maintained. Conclusions: Our findings emphasize the relevance of fatigue in YawMS with low disability levels. Cognitive and emotional processing might be associated with fatigue, beyond and beside disease severity itself.