Chronic fatigue syndrome in children: A cross sectional survey

Institute of Psychiatry and GKT School of Medicine, De Crespigny Park, London SE5 8AF, UK.
Archives of Disease in Childhood (Impact Factor: 2.9). 11/2003; 88(10):894-8. DOI: 10.1136/adc.88.10.894
Source: PubMed


Chronic fatigue syndrome (CFS) in children is a controversial diagnosis with unclear aetiology, ill defined but likely increasing incidence, and debatable clinical management options. However these children experience real and considerable suffering. Appropriate research in this clinical population is sparse and usually occurs in tertiary referral units.
Cross sectional survey of 36 children attending a GP specialist interest clinic in southeast England.
Patient sociodemographics and clinical morbidity were largely comparable to the literature from tertiary referral research centres. Some prognostic indicators for adults did not readily transfer to this younger age group, although several children had a positive family psychiatric history. Receiving treatment was associated with increased school attendance, but one third of subjects obtained no qualifications. Return to normal health or significant overall improvement was reported by 29/36 subjects.
The outcomes in this setting are favourable and comparable to those seen in a controlled setting; this study supports the concept that the prognosis for CFS in children and adolescents is generally good. However, the impact of the illness is significant and this is perhaps most evident in terms of education. Current methods of reporting educational outcomes in the literature are varied and merit development of standardised tools.

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Available from: Trudie Chalder, Oct 05, 2015
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    • "The fatigue scale consists of 14 questions, scored on a four-level scale, with higher scores instead of greater fatigue. Participants were instructed to answer to how they felt during the past two weeks 12 Although Chalder's fatigue scale was developed by Chalder et al. (1993) to assess adult chronic fatigue 12 , Patel et al. (2003) reported results of an assessment of an adolescent population using this scale 3 . "
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    ABSTRACT: Cognitive function was investigated in patients with childhood type chronic fatigue syndrome (CCFS) using the modified advanced trail making test (mATMT). mATMT was performed on 19 patients with CCFS and 25 healthy controls of comparable age and sex. The effectiveness of combined treatment with cognitive behavioral therapy (CBT) and pharmacotherapy and its relationship to cognitive function was investigated by evaluation of Chalder's fatigue scale and behavior state before and after treatment for 6 consecutive months. All three tasks (motor skill, selective and alternative attention, and spatial working memory) of the mATMT, especially the difference in reaction time of the alternative attention task, could discriminate CCFS patients from control subjects with 70.5% accuracy (P=0.007). CCFS patients showed significantly lower alternative attention and Chalder's fatigue score before treatment (P=0.037 and 0.002, respectively). A significant improvement in performance status scores was found during the 6 months follow-up period with combined treatment with CBT and medication (P<0.001). Improvement of their cognitive symptoms was significantly correlated with improvement of alternative attention (r=0.653, P=0.002). Higher-order level cognitive dysfunction affects CCFS pathogenesis. Alternative attention performance evaluated by the mATMT may be used to monitor improvement in patients with CCFS. Combined treatment with CBT and medication may be effective to improve poor attention characteristics associated with CCFS.
    Brain & development 04/2011; 33(10):832-41. DOI:10.1016/j.braindev.2010.12.009 · 1.88 Impact Factor
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    • "Twenty-seven participants is a relative small sample but CFS in young people is still a rare condition (Jordan et al., 2006, De Jong et al., 1997). Our data however, suggest this sample to be comparable with previous studies (Mears et al;, 2004; Patel et al., 2003; Garralda & Rangel, 2004). "
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    ABSTRACT: This paper outlines a conceptualization of and approach to the treatment of psychological symptoms in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) especially symptoms of depression and anxiety. This paper was written due to a perceived need to articulate an approach is under-represented in the medical literature. There are many psychological symptoms not represented in this paper. Only the most common are considered, however the approach discussed may serve as a template for other symptoms. The sources are: a thorough review of the medical literature, the author's experience in a psychiatric practice restricted to patients with ME/CFS, Fibromyalgia and Multiple Chemical Sensitivity and the input of several experienced clinicians and persons suffering from ME/CFS. This topic remains controversial and there are other approaches. However this approach is recommended by being both evidence based and well accepted by patients. The author has given permission for this paper to be posted on the web sites of FM-CFS Canada ( ) and the ME-FM Action Network of Canada ( ) with the goal of increasing discussion and debate and improved outcome for patients. 1. Contents This paper will • Define ME/CFS • Explain why ME/CFS is not a psychiatric disorder despite that a significant subgroup of patients have psychological symptoms. • Outline how to differentiate the symptoms of ME/CFS from those of depression and anxiety • Suggest a treatment approach for common psychiatric symptoms in patients with ME/CFS • Summarize psychological treatment issues in patients with ME/CFS • Summarize issues relevant to children and adolescents with ME/CFS • Discuss the treatment issues of drug sensitivity and the utility of Cognitive Behavior Therapy and Graded Exercise in patients with ME/CFS 2. What is ME/CFS?
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