Tag: overview

Practitioner review: chronic fatigue syndrome in childhood

Abstract:

BACKGROUND: Chronic fatigue syndrome (CFS) is being increasingly recognized in children and adolescents. Yet comparatively little attention has been given in the literature to management.

METHODS: Description of the main features of the disorder, precipitating and maintaining factors and diagnostic assessment. Outline of different views on the nature and treatment of CFS in childhood. Description of a rehabilitation program based on cognitive behavior therapy and graded activity.

RESULTS: Using adult research criteria, CFS can be diagnosed in children and adolescents. In its severe form it is often triggered by infectious illness episodes. It is commonly associated with mood disorders in the child and with mental distress and high levels of emotional involvement in parents. A number of patient support groups hold the view that CFS is a medical disorder, contest a psychiatric contribution and advocate ‘pacing’ as an approach to rehabilitation which includes avoiding activities. To date there is no empirical evidence for the efficacy of this approach. Research in adults, open and clinical reports in children support the use of graded activity and family cognitive behavior therapy. The main aim is to enable children, with the help of their family, to carry out their own rehabilitation with some support and guidance from a health professional. Engaging the child and family in treatment and forming a therapeutic alliance is a continual process and a crucial aspect of management, as many families view the condition as a medical disorder and are initially ambivalent towards this approach.

CONCLUSIONS: There is controversy about the nature and management of CFS in childhood but a rehabilitation program based on family cognitive behavior therapy can be implemented and seems to hold most promise in the management of children with CFS. Family engagement is a crucial aspect of management.

 

Source: Elena Garralda M, Chalder T. Practitioner review: chronic fatigue syndrome in childhood. J Child Psychol Psychiatry. 2005 Nov;46(11):1143-51. http://www.ncbi.nlm.nih.gov/pubmed/16238661

 

Chronic fatigue and chronic fatigue syndrome in the general population

Both chronic fatigue (CF) connected to a chronic or serious disease, and Chronic Fatigue Syndrome (CFS) form a serious problem in our Western society. It causes a lot of suffering for patients and may lead to disability to work. Doctors are frequently confronted with these patients, but it is unknown how many of these patients are suffering without help-seeking.

Most research has been done in CFS, and in specialised CFS clinics. Much less is known about other types of chronic fatigue, connected with a serious disabling disease, or with a psychiatric condition. There is hardly any knowledge about the prevalence and characteristics of these types of chronic fatigue and especially CFS, and the course of CFS in the general population. If we would know more about fatigue and chronic fatigue in the general population then, for example, the development of prevention programs would become nearer.

You can read the rest of this article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC269992/

 

Comment on:

Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population. [Health Qual Life Outcomes. 2003]

A population-based study of the clinical course of chronic fatigue syndrome. [Health Qual Life Outcomes. 2003]

 

Source: Bleijenberg G. Chronic fatigue and chronic fatigue syndrome in the general population. Health Qual Life Outcomes. 2003 Oct 6;1:52. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC269992/ (Full article)

 

Chronic fatigue syndrome in the psychiatric practice

Abstract:

BACKGROUND: Chronic fatigue syndrome (CFS) is a complex syndrome with a psychiatric comorbidity of 70-80%. A psychiatric interview is necessary in order to exclude psychiatric illness and to identify psychiatric comorbidity. Studies have demonstrated that in general medical practice and in the non-psychiatric specialist practice, physicians tend to underdiagnose psychopathology in patients with CFS. There are many questions unanswered about the treatment of CFS Aim: Typical issues for the psychiatric practice are reviewed: psychiatric comorbidity, dysregulation of the PHA-axis and the treatment of CFS.

CONCLUSIONS: Depression, somatization, sleeping disorders and anxiety disorders are the most important psychopathological symptoms found in CFS patients. CFS should not be regarded as a masked (somatoform) depression. Although the results from neuroendocrinological studies assessing the hypothalamic-pituitary-adrenal axis (HPA-axis) are inconsistent, they suggest that there is a subgroup of CFS patients suffering from a discrete dysregulation of the HPA-axis resulting in basal hypocortisolaemia. These findings, however, do not reveal a causal relationship. Antidepressants do not seem to have a positive influence on the symptom of fatigue, but appear to be beneficial in alleviating the symptoms of depression and social functioning. Cognitive behaviour therapy and graded exercise show a significant improvement on fatigue and other symptoms and are the only treatments available for CFS patients.

 

Source: Van Duyse A, Mariman A, Poppe C, Michielsen W, Rubens R. Chronic fatigue syndrome in the psychiatric practice. Acta Neuropsychiatr. 2002 Jun;14(3):127-33. doi: 10.1034/j.1601-5215.2002.140306.x. http://www.ncbi.nlm.nih.gov/pubmed/26984154

 

Epidemiologic advances in chronic fatigue syndrome

Abstract:

Epidemiologic studies of chronic fatigue syndrome (CFS) have been hampered by the absence of a specific diagnostic test, but with increasing interest in this disorder there has been a greater understanding of the risk factors, illness patterns, and other aspects of this multisystem disorder.

Working case definitions have been developed for research purposes but they have continued to change over time and have not always been utilized precisely by various investigators. This has been a major factor in the widely varying estimates of prevalence rates, but two different studies using the same working definition and including a medical work-up have estimated the prevalence to be approximately 200/100,000. Clusters of CFS cases, which appear to be related to earlier reports of “epidemic neuromyasthenia”, have attracted considerable attention and appear to be well documented, although investigated with varying methodology and often with dissimilar case definitions.

Risk factors for cases occurring in clusters and sporadically appear to be similar, the most consistent ones being female gender and the co-existence of some form of stress, either physical or psychological. The prognosis of CFS is difficult to predict, although cases occurring as part of clusters appear to have a better prognosis as a group than sporadic cases, and those with an acute onset have a better prognosis than those with gradual onset.

It is highly unlikely that there is a single agent, infectious or noninfectious, that is responsible for more than a small proportion of CFS cases and, at the present time, the risk factors for developing CFS appear to lie more prominently in the host rather than the environment.

 

Source: Levine PH. Epidemiologic advances in chronic fatigue syndrome. J Psychiatr Res. 1997 Jan-Feb;31(1):7-18. http://www.ncbi.nlm.nih.gov/pubmed/9201643

 

The history and treatment of chronic fatigue syndrome

Abstract:

This article looks at chronic fatigue syndrome, a common condition affecting 1-2.5% of the population. The criteria for diagnosis are described and the nurse’s role in treatment is discussed.

 

Source: Ross E. The history and treatment of chronic fatigue syndrome.  Nurs Times. 1996 Oct 30-Nov 5;92(44):34-6. http://www.ncbi.nlm.nih.gov/pubmed/8945330