This study sought to examine the association between sleep, fatigue, and functional health in psychotic patients. Participants included 93 psychotic inpatients ( with schizophrenia) who completed the Chalder Fatigue Scale (ChFS), the Fatigue Symptom Inventory (FSI), the Pittsburgh Sleep Quality Index (PSQI), and the SF36 Health Survey. Patients were classified on the basis of their performance on sleep and fatigue measures: 60% reported significant levels of fatigue and 67% significant sleep disturbances. 28.4% reported both, suggesting that fatigue and sleep dysfunctions do not necessarily cooccur. A closer examination of patterns showed that fatigue was only related to qualitative aspects of sleep and not quantifiable aspects of sleep disturbances. The results also showed that functional health was the lowest in patients with high levels of fatigue, compared to patients with sleep problems only or patients with neither symptom. A regression analysis further showed that the size of the contribution of fatigue onto functional health was twice as much as that of sleep dysfunctions. In conclusion, the results show that (i) dissatisfaction with sleep—and not sleep itself—is related to fatigue symptoms and that (ii) fatigue is particularly detrimental to functional health, regardless of the presence of sleep dysfunctions. 1. Introduction Fatigue is a condition characterised by persistent weakness or exhaustion and a combination of symptoms that feature self-reported impairments in some of the following: impaired attention and concentration, headaches, unrefreshing sleep, and/or musculoskeletal pain [1]. Fatigue is an experiential state typically diagnosed on the basis of self-reports and is a common complaint in the general population [2, 3]. It is usually associated with middle age, being female, and having lower education and occupation attainment [4]. Fatigue is common in psychiatric conditions such as anxiety and depression (25–36%) [5–7] and in chronic medical conditions such as cancer, Parkinson’s disease, multiple sclerosis, diabetes, and viral infection [8–12]. Fatigue worsens with increasing physical disease severity [10] and is independent of medication suggesting that medication itself is not responsible for fatigue. Studies of fatigue in patients with psychotic disorders such as schizophrenia or bipolar disorder are currently lacking. Yet several reasons support an investigation into fatigue symptoms in these individuals. First, the functional impairments associated with fatigue include considerable impairments and disability [13, 14] pointing
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