Chronic Fatigue Syndrome in Children and Adolescents: A Review Article

Abstract

Clinicians have been describing individuals with chronic fatigue states for over 100 years, although chronic fatigue syndrome is often regarded as a modern disease. The aetiology of chronic fatigue syndrome is uncertain. For young individuals with chronic fatigue syndrome there are neither reliable prevalence figures nor scientific evidence concerning the effectiveness of treatments. Information obtained from research into adult individuals with chronic fatigue syndrome may be helpful but is not necessarily directly applicable to children and adolescents. Developmental factors and the influence of other family members on the course of the disorder in young sufferers should be considered. The uncertainties surrounding chronic fatigue syndrome should not deter child and adolescent mental health workers from becoming involved in the assessment and management of individual patients. The mainstay of treatment is rehabilitation with an emphasis on gradually increasing activities. Considerable attention will need to be given to engaging the young people and their families and working effectively with a multidisciplinary team. If mental health workers do not become involved in treating young people with chronic fatigue syndrome there is a risk that psychological factors will not be addressed and that chronic functional impairment will ensue.

Chronic fatigue syndrome in children: a cross sectional survey

“…Similarly another study 41 has reported that 77% of their 35 patients had a gradual illness onset, and together these findings challenge the more commonly reported acute onset. 12 For prognostic factors, we endorse that CFS in children be considered as an entity separate to that found in adults, 6 as several common adult prognostic factors 1 18 occur less frequently in children. However, a familial influence was seen in five subjects and others had a positive family psychiatric history.…”

“…3 4 Prolonged school absenteeism is also occasionally included in the definition as a proxy measure for functional impairment and severity. 5 Epidemiological studies for CFS in children are sparse, 6 although in the Netherlands, the prevalence in teenagers has been reported as 10-20 per 100 000 inhabitants. 5 In Australia, eight of 42 CFS cases were found to be under the age of 15.…”

“…Disruption to education, social, recreational, and peer group integration should be minimised. 9 The use of antidepressants in children has been advocated, 6 where depression is a significant feature (as often seen in CFS), based on evidence provided. 21 22 Unfortunately, CFS in children has received much adverse publicity.…”

Why do young people with CFS/ME feel anxious? A qualitative study

“…This has been postulated to help avoid feelings of guilt, stigma or blame related to the illegitimacy of the illness (Guise, Widdicombe, & McKinlay, 2007). However, while this has been shown in an adult population, Richards (2004) suggests the impact of CFS/ME is likely to be different for young people. In particular, a long period of illness and absences from school, friends, and activities can have a larger impact on academic, social and emotional development due to the rapid changes taking place during this developmental stage (Boice, 1998).…”

Chronic fatigue syndrome: a qualitative investigation of young patient's beliefs and coping strategies

“…As the understanding of CFS/ME in young people is relatively poor and, with a few exceptions [10,11], qualitative research on this patient population is meagre, existing literature and national guidelines for young patients with CFS/ME have emphasised the need for further quantitative and qualitative research [12][13][14]. As information obtained from research into the adult population is not necessarily applicable to young patients [11,12], and beliefs of the patients in their own terms is not necessarily best captured by quantitative inquiry using standard questionnaires, we wanted to explore in-depth the illness experience of young patients with CFS/ME by using a qualitative methodology. More specifically, we wanted to investigate the nature and function of two aspects of adolescents' illness experience: attribution and coping strategies.…”