Article

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: 2.91). 11/2003; 88(10):894-8. DOI: 10.1136/adc.88.10.894
Source: PubMed

ABSTRACT 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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    ABSTRACT: Objectives: Although pain is a significant symptom in chronic fatigue syndrome (CFS), pain is poorly understood in adolescents with CFS. The aim of this study was to explore pain distribution and prevalence, pain intensity and its functional interference in everyday life, as well as pressure pain thresholds (PPT) in adolescents with CFS and compare this with a control group of healthy adolescents (HC). Methods: This is a case-control, cross-sectional study on pain including 120 adolescents with CFS and 39 HCs, aged 12-18 years. We measured pain frequency, pain severity and pain interference using self-reporting questionnaires. PPT was measured using pressure algometry. Data were collected from March 2010 until October 2012 as part of the Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial. Results: Adolescents with CFS had significantly lower PPTs compared with HCs (p<0.001). The Pain Severity Score and the Pain Interference Score were significantly higher in adolescents with CFS compared with HCs (p<0.001). Almost all adolescents with CFS experienced headache, abdominal pain and/or pain in muscles and joints. Moreover, in all sites, the pain intensity levels were significantly higher than in HCs (p<0.001). Conclusions: We found a higher prevalence of severe pain among adolescents with CFS and lowered pain thresholds compared with HCs. The mechanisms, however, are still obscure. Large longitudinal population surveys are warranted measuring pain thresholds prior to the onset of CFS.
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    ABSTRACT: Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is a heterogeneous condition that causes significant morbidity in young people. Its cause is unknown with current evidence suggesting that, in mild and moderate cases, cognitive behaviour therapy and/or graded exercise should be the treatment of choice. The majority of adolescents will improve or get better. Further research is required to determine aetiology and optimum management.
    Current Paediatrics 06/2005; 15(3):246-252. DOI:10.1016/j.cupe.2005.02.009

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