Tag: adolescents

Chronic fatigue syndrome and other fatiguing illnesses in adolescents: a population-based study

Abstract:

PURPOSE: To estimate the prevalence of chronic fatigue syndrome (CFS) and describe characteristics of other fatiguing illnesses in adolescents (aged 12 through 17 years).

METHODS: We conducted a random digit dialing survey of the residents of Wichita, Kansas. Adults identified fatigued adolescents in the household and answered questions relating to the child’s health. Selected adolescents were invited to attend a clinic with a parent/guardian. After clinical evaluation they were classified as CFS or another fatigue state as defined in the 1994 CFS definition. Annual telephone interviews and clinical evaluations monitored subjects’ fatigue status. Data were analyzed using the Kruskal-Wallis test, the Mantel-Haenszel test, and the exact McNemar test.

RESULTS: The survey contacted 34,018 households with 90,316 residents. Of 8586 adolescents, 138 had fatigue for > or =1 month and most (107 or 78%) had chronic fatigue (> or =6 months) at some point during the 3-year follow-up. Twenty-eight had exclusionary diagnoses. Thirty-one were considered to have a CFS-like illness and were invited for clinical evaluation. Eleven agreed to participate and none met the CFS case definition. The baseline weighted prevalence of CFS-like illness was 338 per 100,000. Significant differences existed between parental and adolescents’ descriptions of illness.

CONCLUSIONS: The prevalence of CFS among adolescents was considerably lower than among adults. Evaluation of CFS in adolescents must consider both parent and patient perception of fatigue and other illnesses that might explain the symptom complex.

 

Source: Jones JF, Nisenbaum R, Solomon L, Reyes M, Reeves WC. Chronic fatigue syndrome and other fatiguing illnesses in adolescents: a population-based study. J Adolesc Health. 2004 Jul;35(1):34-40. http://www.ncbi.nlm.nih.gov/pubmed/15193572

 

Prevalence of chronic disabling fatigue in children and adolescents

Abstract:

BACKGROUND: The epidemiology of chronic fatiguing illnesses in young people is poorly understood.

AIMS: To estimate the lifetime prevalence of different definitions of chronic fatigue in 8- to 17-year-olds.

METHOD: Participants came from two population-based twin series. Parents completed self-report questionnaires that inquired whether either child had ever experienced more than a few days of disabling fatigue. Telephone interviews were undertaken for individuals who had experienced such an episode.

RESULTS: Questionnaires were returned by 1468 families (65% response rate) and telephone interviews were undertaken regarding 99 of the 129 subjects (77%) who had experienced fatigue. The lifetime prevalence estimates ranged from 2.34% (95% CI 1.75-2.94) for disabling fatigue lasting 3 months to 1.29% (95% CI 0.87-1.71) for a disorder resembling adult operationally defined chronic fatigue syndrome.

CONCLUSIONS: From the age of 11 years, young people have similar rates and types of chronic fatiguing illnesses to adults.

 

Source: Farmer A, Fowler T, Scourfield J, Thapar A. Prevalence of chronic disabling fatigue in children and adolescents. Br J Psychiatry. 2004 Jun;184:477-81. http://bjp.rcpsych.org/content/184/6/477.long  (Full article)

 

Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders

Abstract:

BACKGROUND: Functional impairment is a key feature of chronic fatigue syndrome (CFS) of childhood.

AIM: To compare impairment, illness attitudes and coping mechanisms in childhood CFS and in other paediatric disorders.

METHOD: Participants were 28 children and adolescents with CFS, 30 with juvenile idiopathic arthritis (JIA) and 27 with emotional disorders (ED). The measures used were interviews with children and parents, with detailed enquiry on impairment, including the Functional Disability Inventory (FDI), Illness Attitudes Scales (IAS), and Kidcope to measure coping styles in relation to common problems, illness and disability.

RESULTS: Children with CFS reported significantly more illness impairment, especially in school attendance, than those with JIA and ED. They had higher ‘worry about illness’ scores on the IAS. On the Kidcope they named school issues (work, expectations, attendance) as illness- or disability-related problems more than the other two groups. Fewer CFS participants reported using problem solving as a strategy to cope with illness and disability than with other problems in their lives. More in the CFS than in the JIA group used emotional regulation to cope with illness and disability. Fewer in the CFS than in the ED groups used social withdrawal to cope with illness and self-criticism for disability, but more used resignation to cope with disability.

CONCLUSION: Severe illness-related impairment, particularly through school non-attendance, and high levels of illness-related school concerns appear specific to CFS. CFS may also have characteristically high levels of generalised illness worry and particular styles of coping with illness and disability.

 

Source: Garralda ME, Rangel L. Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders. J Child Psychol Psychiatry. 2004 Mar;45(3):543-52. http://www.ncbi.nlm.nih.gov/pubmed/15055373

 

Chronic fatigue syndrome in adolescents: a follow-up study

Abstract:

OBJECTIVES: To compare the frequency of persistent symptoms up to 8 years after illness onset in adolescents diagnosed as having chronic fatigue syndrome, idiopathic chronic fatigue, and unexplained fatigue for less than 6 months, and to determine if hospital admission is associated with outcome.

DESIGN: A cohort study using questionnaire follow-up.

SETTING: A tertiary referral hospital.

PATIENTS: Consecutive adolescents referred for assessment of persistent fatigue were identified and retrospectively divided into 3 groups according to the diagnostic criteria for chronic fatigue syndrome and idiopathic chronic fatigue.

INTERVENTION: A questionnaire was designed and administered by telephone at a mean of 4.57 years after the initial examination.

MAIN OUTCOME MEASURE: The persistence of self-reported symptoms was compared with respect to patient group and admission.

RESULTS: Outcome data were obtained for 34 (69%) of the 49 eligible subjects. Twenty-five percent of the chronic fatigue syndrome group showed near to complete improvement, 31% showed partial improvement, and 44% showed no improvement. The idiopathic chronic fatigue group had near to complete recovery in 50%, partial in 10%, and no improvement in 40%. Those with unexplained fatigue for less than 6 months had all recovered. There was no difference between the outcome of the subjects admitted to the hospital and those managed as outpatients.

CONCLUSIONS: Adolescents with less than 6 months of fatigue have a good outcome. Unexplained fatigue lasting more than 6 months has a similar outcome regardless of the presence of minor criteria for chronic fatigue syndrome.

Comment in: Adolescent chronic fatigue syndrome. [Arch Pediatr Adolesc Med. 2004]

 

Source: Gill AC, Dosen A, Ziegler JB. Chronic fatigue syndrome in adolescents: a follow-up study. Arch Pediatr Adolesc Med. 2004 Mar;158(3):225-9. http://www.ncbi.nlm.nih.gov/pubmed/14993080

 

Chronic fatigue syndrome in children: a cross sectional survey

Abstract:

BACKGROUND: 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.

METHODS: Cross sectional survey of 36 children attending a GP specialist interest clinic in southeast England.

RESULTS: 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.

CONCLUSIONS: 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.

 

Source: Patel MX, Smith DG, Chalder T, Wessely S. Chronic fatigue syndrome in children: a cross sectional survey. Arch Dis Child. 2003 Oct;88(10):894-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1719321/ (Full article)

 

Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds: cross sectional study

Chronic fatigue syndrome is characterised by severe physical and mental fatigue associated with disability, which by definition markedly affects people’s lives. At one end of the spectrum, newspaper headlines imply that chronic fatigue syndrome or myalgic encephalomyelitis in children is of epidemic proportions, whereas at the other end the existence of the disorder is refuted. Attempts have been made to assess the size of the problem in the community, general practice, schools, and secondary care.w1-w5 Methodological problems, however, such as selection biases and poor response rates make it difficult to draw conclusions from these studies. We are unaware of any population studies in the United Kingdom that examine the prevalence of and factors associated with chronic fatigue syndrome in children. We determined the prevalence of chronic fatigue, chronic fatigue syndrome, and reported myalgic encephalomyelitis in 5-15 year olds and examined demographic and psychiatric associations.

You can read the rest of this article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC196393/

 

Source: Chalder T, Goodman R, Wessely S, Hotopf M, Meltzer H. Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds: cross sectional study. BMJ. 2003 Sep 20;327(7416):654-5.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC196393/ (Full article)

Relationship between chronic fatigue and subjective symptoms of fatigue with performance status (P.S.) and subjective fatigue scale for young adults (SFS-Y)

Abstract:

OBJECTIVE: Today, fatigue complaints in adolescence are regarded as an issue for young adults as they may progress to the chronic fatigue syndrome. The purpose of this study was to examine the relationships between chronic fatigue based on self-reported performance states (P.S.) and subjective symptoms of fatigue assessed with a fatigue scale for young adults (SFS-Y).

METHOD: The SFS-Y consisted of 24 item questions represonting 6 sub-scales, for difficulty in concentrated thinking, languor, reduced activation, reduced motivation, drowsiness and feeling of physical disintegration. The SFS-Y and for assessing fatigue symptoms and P.S. for chronic fatigue were administered to 548 male and female students aged 15-18 yr and to 608 male students aged 16-18 yr, respectively. Discriminant analysis and a logistic analysis model were employed to define the relevance of subjective symptoms of fatigue to chronic fatigue.

RESULTS: It was determined that the SFS-Y can discliminate P.S. with high probability (74.0-81.4%), with accuracy beyond a fixed level. In particular, the correlation with “difficulty in concentrated thinking” was high.

CONCLUSION: It was judged that the SFS-Y is effective as an index for discrimination of chronic fatigue in young adults with a particularly high relationship between “difficulty in centrated thinking” and chronic fatigue.

 

Source: Kobayashi H, Demura S. Relationship between chronic fatigue and subjective symptoms of fatigue with performance status (P.S.) and subjective fatigue scale for young adults (SFS-Y). Nihon Koshu Eisei Zasshi. 2002 Oct;49(10):1062-9. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/12462040

 

Asthenia in adolescents

Abstract:

Fatigue is defined as a subjective sensation of tiredness or weariness that occurs at rest. The perception of fatigue among 12-15 years-old Italian adolescents in a school survey was about 70%. Generally the symptoms are reported after a viral illness or an infection. In adolescents with persistent or severe fatigue a selected screening evaluation to look for an underlying organic disorder is warranted. A practical diagnostic approach is given and a brief description of chronic fatigue syndrome is reported according to CDC revised diagnostic criteria published in 1997.

 

Source: De Sanctis V, Mangiagli A, Campisi S, Raiola G. Asthenia in adolescents. Minerva Pediatr. 2002 Dec;54(6):631-7. [Article in Italian] http://www.ncbi.nlm.nih.gov/pubmed/12388954

 

Symptom or illness? The exhausting life of an adolescent with chronic fatigue syndrome

Abstract:

This case report presents the assessment of a 16-year old boy with chronic fatigue syndrome (CFS). Questions on the etiology, dynamics, diagnostics and treatment of this complex condition are briefly discussed.

 

Source: Di Gallo A. Symptom or illness? The exhausting life of an adolescent with chronic fatigue syndrome.  Z Kinder Jugendpsychiatr Psychother. 2002 May;30(2):135-40. [Article in German] http://www.ncbi.nlm.nih.gov/pubmed/12053877

 

Chronic fatigue syndrome: successful outcome of an intensive inpatient programme

Abstract:

OBJECTIVE: To study the outcome of adolescents with chronic fatigue syndrome (CFS) following an intensive multi-disciplinary inpatient programme.

METHODS: A follow-up questionnaire was distributed to all 57 adolescents who had completed the CFS inpatient programme at the Austin and Repatriation Medical Centre.

RESULTS: Forty-two adolescents (74%) returned follow-up questionnaires. Immediately following the programme and up to five years after the programme, the majority of participants had returned to school and were functioning better in terms of physical activity and social interactions as compared with before the programme. Before the programme, 94% of adolescents were attending school half-time or less. Up to 5 years after the programme, 78% of adolescents were attending school full-time or with occasional absences only.

CONCLUSIONS: A multidisciplinary inpatient programme for CFS was successful in helping to rehabilitate this group of adolescents who were significantly incapacitated prior to entering the inpatient programme.

 

Source: Lim A, Lubitz L. Chronic fatigue syndrome: successful outcome of an intensive inpatient programme. J Paediatr Child Health. 2002 Jun;38(3):295-9. http://www.ncbi.nlm.nih.gov/pubmed/12047700