Predictors of Persistent and New-onset Fatigue in Adolescent Girls

Abstract

The stability of severe fatigue among adolescents is substantial. The involvement in the onset and persistence of fatigue suggests that both preventive and therapeutic strategies with respect to fatigue treatment in adolescents should concentrate on emotional well-being. Moreover, adolescents at risk should be stimulated to spend more time on physical activities and to sleep longer.

Risk Factors for Persistent Fatigue With Significant School Absence in Children and Adolescents

“…Female gender was a very strong predictor of a more severe outcome. The percentage of persistent fatigue patients was much higher than in a school-based group of fatigued children, 13 where 25.7% of the children were persistently fatigued after 1 year. Not all of the persistently fatigued patients in our study developed significant school absence, with only 16 patients (20.3%) missing Ͼ50% of their classes.…”

“…The level of exercise the patient was engaged in before the onset of fatigue may be another important prognostic factor. Little 10 and much [11][12][13] physical activity in sports both are known risk factors for the development of CFS.…”

The epidemiology of chronic fatigue syndrome/myalgic encephalitis in children

“…Reduced physical activity may be associated with new onset of fatigue 12 months later32 and with extreme tiredness occurring more than once a week in adolescents12 but the effect on CFS/ME is not known. Both excessive exercise and sedentary behaviour are plausible risk factors and further investigation is required to understand the complex nature of exercise and fatigue.…”

“…It is not known whether the associated mood disorders contribute to the development of CFS/ME or are caused by it 39. There are currently no longitudinal studies that are sufficiently powered to investigate this, although several describe an association between mood disorders and later onset of fatigue 8 12 32…”

Cortisol output in adolescents with chronic fatigue syndrome: Pilot study on the comparison with healthy adolescents and change after cognitive behavioural guided self-help treatment

“…For example, perfectionist or conscientious individuals may strenuously attempt to keep up with their usual standards despite the extra challenges, and end up more stressed and fatigued as a result (e.g., [9]). It is suggested that acute fatigue can become chronic via a number of mechanisms including level of physical activity (e.g., too high or too low; [42]), fearful beliefs about fatigue or the effects of fatigue (e.g., [38]) or emotional difficulties such as anxiety or depression [30,32]. Cognitive behavioural interventions typically aim to improve symptoms and functioning by (a) encouraging patients to achieve a balance between activity and rest, (b) gradually increasing activities, (c) establishing a sleep routine, (d) addressing unhelpful beliefs (e.g., about fatigue or high standards) and (e) paying attention to relapse prevention.…”