Chronic Fatigue Syndrome in children and young people

MacKenzie, Carrie; Wray, Alison

doi:10.1016/j.paed.2012.10.001

Cited by 10 publications

(14 citation statements)

References 9 publications

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“…In this study, clinicians discussed the need to balance treatment and outcomes across physical, social and psychological areas of a child’s life. This is consistent with the literature on the impact of CFS/ME on children’s function [ 10 ], schooling [ 4 , 12 , 33 , 34 ], social activities [ 35 – 38 ], family [ 39 – 41 ] and emotional function [ 37 , 38 , 42 – 47 ].…”

Section: Discussionsupporting

confidence: 91%

“…This is consistent with the strongest finding in a recent review, with higher rates psychiatric co-morbidity in children with CFS/ME compared to healthy controls or other illness groups [ 52 ]. CFS/ME families have been found to identify with the concept of vicious cycles arising as a consequence of the condition [ 39 ]. Patients are said to avoid activity due to the resulting symptoms that then leads to more symptoms due to physical deconditioning [ 53 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, setting baselines to reduce boom and bust, realistic individual goals and giving children hope for the future were key treatment priorities. Mackenzie and Wray [ 39 ] advocated the importance reassuring patients and their carers that they will recover and go on to achieve academic qualifications.…”

Section: Discussionmentioning

confidence: 99%

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Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services.

et al. 2017

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BackgroundPaediatric Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) is relatively common and disabling. Improving treatment requires the development of Patient Reported Outcome Measures (PROMs) that enable clinicians and researchers to collect patient-centred evidence on outcomes. Health professionals are well placed to provide clinical insight into the condition, its treatment and possible outcomes. This study aimed to understand the perspectives of specialist paediatric CFS/ME health professionals and identify outcomes that are clinically important.MethodsFocus groups and interviews were held with 15 health professionals involved in the care of children with CFS/ME from the four largest specialist paediatric CFS/ME services in the NHS in England. A range of clinical disciplines were included and experience in paediatric CFS/ME ranged from 2 months to 25 years. Ten participants (67%) were female. Focus groups and interviews were recorded, transcribed verbatim and data were analysed using thematic analysis.ResultsAll health professionals identified the impact of CFS/ME across multiple aspects of health. Health professionals described four areas used to assess the severity of the illness and outcome in children: 1) symptoms; 2) physical function; 3) participation (school, activities and social life); and 4) emotional wellbeing. They also described the complexity of the condition, contextual factors and considerations for treatment to help children to cope with the condition.ConclusionsClinically important outcomes in paediatric CFS/ME involve a range of aspects of health. Health professionals consider increases in physical function yet maintaining school functioning and participation more widely as important outcomes from treatment. The results are similar to those described by children in a recent study and will be combined to develop a new child-specific PROM that has strong clinical utility and patient relevance.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services.

et al. 2017

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“… 2 The estimated prevalence of paediatric CFS/ME is between 1% and 2.4% depending on the methodology and diagnostic criteria used. 3 4 There are a number of recognised and widely accepted diagnostic criteria for CFS/ME, including the Centers for Disease Control and Prevention (CDC) criteria, also known as the Fukuda definition, 5 the Oxford 6 criteria and the criteria defined by the National Institute for Health and Care Excellence 7 ( table 1 ). In summary, to meet a diagnosis of CFS/ME, these criteria require the presence of recurrent or persistent fatigue which is debilitating, has lasted for at least 3 7 or 6 months 5 in duration but is not lifelong, is not explained by ongoing exertion, is not alleviated by rest, is not explained by other conditions (including depression) and has a substantial impact on activity.…”

Section: Introductionmentioning

confidence: 99%

Treatment for paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) and comorbid depression: a systematic review

2016

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ObjectivesAt least 30% of young people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) also have symptoms of depression. This systematic review aimed to establish which treatment approaches for depression are effective and whether comorbid depression mediates outcome.SettingA systematic review was undertaken. The search terms were entered into MEDLINE, EMBASE, PsycInfo and the Cochrane library.ParticipantsInclusion and exclusion criteria were applied to identify relevant papers. Inclusion criteria were children age <18, with CFS/ME, defined using CDC, NICE or Oxford criteria, and having completed a valid assessment for depression.Results9 studies were identified which met the inclusion criteria, but none specifically tested treatments for paediatric CFS/ME with depression and none stratified outcome for those who were depressed compared with those who were not depressed. There is no consistent treatment approach for children with CFS/ME and comorbid depression, although cognitive–behavioural therapy for CFS/ME and a multicomponent inpatient programme for CFS/ME have shown some promise in reducing depressive symptoms. An antiviral medication in a small scale, retrospective, uncontrolled study suggested possible benefit.ConclusionsIt is not possible to determine what treatment approaches are effective for depression in paediatric CFS/ME, nor to determine the impact of depression on the outcome of CFS/ME treatment. Young people with significant depression tend to have been excluded from previous treatment studies.

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“…The evidence-based treatment approach for CFS/ME includes activity management (NICE, 2007), which enables young people to circumvent the typical boom-and-bust pattern of activity by finding a manageable baseline of high energy activities, and subsequently gradually increasing this. There is some evidence that cognitive behavioral treatment (CBT) or a multi-component inpatient program (including psychology and physiotherapy input over 4 weeks) is effective in young people with CFS/ME (Browne & Chalder, 2006;Gordon & Lubitz, 2009;Knoop, Stulemeijer, de Jong, Fiselier, & Bleijenberg, 2008;Mackenzie & Wray, 2013). The Dutch FITNET trial found that Internet-delivered CBT was more effective than usual care at improving school attendance and physical function, and reducing fatigue in adolescents, age 12-18, with CFS/ME (Nijhof, Bleijenberg, Uiterwaal, Kimpen, & van de Putte, 2012).…”

mentioning

confidence: 99%

The Cognitive Behavioral Treatment of Depression and Low Self‐Esteem in the Context of Pediatric Chronic Fatigue Syndrome (CFS/ME): A Case Study

Loades

2015

Child Adoles Psych Nursing

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Therapy was effective in remediating the young person's mood difficulties, but appeared to exacerbate their CFS/ME symptoms. Therefore, it is crucial that CFS/ME and mood treatments are designed and trialed to ensure a complementary approach. Good communication and joint working between involved professionals is also important, and ideally, treatments for mood and for CFS/ME would be provided by the same team to facilitate this.

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Chronic Fatigue Syndrome in children and young people

Cited by 10 publications

References 9 publications

Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services.

Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services.

Treatment for paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) and comorbid depression: a systematic review

The Cognitive Behavioral Treatment of Depression and Low Self‐Esteem in the Context of Pediatric Chronic Fatigue Syndrome (CFS/ME): A Case Study

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