The Prevalence of Chronic Fatiguing Illnesses Among Adolescents in the United States

Abstract

Objective. To compare the prevalence of unexplained chronic fatigue (CF) and chronic fatigue syndrome (CFS) among adolescents in three studies conducted by the Centers for Disease Control and Prevention and to compare these estimates with those for adults in two of the studies.Design. The studies used the following three designs: (i) a physician-based CFS surveillance system, (ii) a random, cross-sectional community telephone survey and (iii) a cross-sectional survey of school nurses.Setting. Surveillance included all patients with unexplained fatigue seen by participating physicians in four communities over a 2-year period; the community survey was conducted in a defined, urban population; and the survey of nurses included all middle, junior, and high school nurses in two communities.Patients or other participants. Twenty-three adolescent cases of unexplained chronic fatiguing illness were reported to the surveillance system, 7 of whom were classified with CFS. The community survey screened 2,249 persons between the ages of 2 and 17 years and identified 5 with unexplained chronic fatiguing illness, only one of whom might have had CFS. The school nurses identified 22 students with unexplained fatiguing illness, 10 of whom had received a diagnosis of CFS.Main outcome measures. The prevalence of unexplained chronic fatiguing illness was estimated in all three studies. The prevalence of CFS was estimated in one study, the prevalence of CFS-like illness was estimated in another, and the prevalence of a reported diagnosis of CFS was estimated in the third.Results. In general, the prevalence estimates of CF, CFS-like illness, and CFS for adolescents were lower than those for adults. One study also included children ages 2 to 11 years and found very little CF and no CFS. Cases of CFS among adolescents were evenly distributed across individual years of age.Conclusions. CFS was clearly present among adolescents, although the prevalence for this group was lower than for most adult age groups. Differences in prevalence estimates among the three studies were consistent with differences in study designs. The validity of adolescent/adult comparisons within each study should not be affected by the study design. Further study of the applicability of the current CFS case definition to adolescents is warranted.