Chronic Fatigue Syndrome In Children Research Articles

Chronic Fatigue Syndrome in children population – current knowledge summary

Chronic Fatigue Syndrome/Myalgic Encephalomyelits (CFS/ME) is a chronic disease with complex pathophysiology and unknown etiology. It occurs both in children and adolescents, as well as in adults, with equal frequency. The clinical course is characterized by progressive fatigue, a significant reduction in the body's efficiency, lack of relief despite rest, and numerous accompanying symptoms. Pathognomonic symptom for PE is the increase in fatigue after physical or mental exertion and the persistence of these symptoms for several hours or days. The basis for effective treatment is primarily non-pharmacological treatment, including determining the optimal balance between physical activity and rest, which is aimed at preventing post-workout fatigue. Pain, insomnia, IO, and other symptoms can be treated with medication. So far, little research has been done on the diagnosis and treatment of this disease in children. This publication aims to summarize the knowledge currently available on the Chronic Fatigue Syndrome in children and adolescents.

Epidemiology of paediatric chronic fatigue syndrome in Australia

ObjectiveTo estimate the paediatrician-diagnosed incidence of chronic fatigue syndrome (CFS) in Australia, and describe demographic and clinical features, as well as approaches to diagnosis and management.MethodsThe Australian Paediatric Surveillance Unit...

Effects of Sleep Habits and Attention Control on Chronic Fatigue Syndrome in Children

Effects of Sleep Habits and Attention Control on Chronic Fatigue Syndrome in Children

CFS in Children and Adolescent: Ten Years of Retrospective Clinical Evaluation.

Aim. To estimate number of children being diagnosed with chronic fatigue syndrome (CFS). Methods. For a period of 10 years (2002–2011) data from children being referred for fatigue symptoms were collected retrospectively. Results. Thirty-seven children were referred. Four were excluded due to incorrect coding. Six (18%) patients received other diagnoses at the end of evaluation time. Of the 27 who received the diagnosis G93.3, four had a previous chronic illness, while 23 patients were previously healthy. All patients reported onset of fatigue symptom in relation to an infection, and all tested positive for IgG to either Epstein-Barr virus, cytomegalovirus or borrelia, indicating previous infection. There were 16 (59%) boys among the 27 patients. The mean age at the debut of fatigue symptoms was 141 months (SD 30) for boys and 136 months (SD 31) for girls, respectively. Being underweight, defined as BMI < 17.5, was found in 12 (44%) patients. Conclusion. An increasing number of children and adolescents are evaluated for CFS. The clinical assessment of children and adolescents with possible CFS need systematically evaluation. Nutritional status, possible eating disorder, and psychosocial issues need to be addressed and evaluated carefully. A multidisciplinary approach is essential when assessing CFS in children and adolescents. There is a need for European guidelines.

Fibromyalgia and chronic fatigue syndrome in children

Fibromyalgia (FM) is characterized by widespread persistent pain and the presence of multiple discrete tender points. Chronic fatigue syndrome (CFS) is a syndrome characterized by debilitating fatigue associated with a variable number of non-specific complaints. Because neither condition had necessarily been recognized in children until recently, those patients have been treated as having school refusal without being diagnosed as having either syndrome. There is a considerable overlap of clinical symptoms between these two syndromes. It is therefore controversial as to whether these syndromes have the same pathogenesis or not. The aim of the present study was to clarify the relationship between these syndromes in children. Fifteen patients with FM and 21 patients with CFS were investigated both clinically and immunologically. Immunological assessments included thorough analysis of autoantibodies using several techniques. Anti-nuclear antibody titers were higher and the prevalence of anti-Sa antibody was far more frequent in CFS patients than in FM patients. CFS and FM are different from each other at least in childhood, from an immunological aspect, although some patients could have both conditions.

Phenotypes of chronic fatigue syndrome in children and young people

ObjectiveTo investigate the heterogeneity of chronic fatigue syndrome (CFS/ME) in children and young people.SettingRegional specialist CFS/ME service Patients Children and young people aged <19 years old.MethodsExploratory factor analysis was performed...

Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is characterized by disabling fatigue that significantly interferes with people's ability to carry out their normal daily activities. This article describes the core symptoms and details diagnostic criteria, in addition to discussing aetiology, risk factors, onset, prognosis and prevalence. Many patients diagnosed with CFS also meet the criteria for common psychiatric disorders, particularly depression. Issues regarding co-morbidity and the relationship between CFS and psychiatric illness are discussed. We outline two popular approaches to understanding CFS; the cognitive behavioural and deconditioning paradigms. The cognitive behavioural model attempts to explain how life stresses can precipitate CFS in predisposed persons, and how cognitive, physiological, behavioural and social factors then interact to perpetuate the illness creating a vicious cycle of chronic fatigue and disability. Deconditioning, a physiological process leading to a decrease in the body's efficiency, reduces the body's capacity for physical exertion, leading to an increase in fatigue symptoms at lower levels of exercise than previously. Treatments for CFS are discussed, with the focus being on two non-pharmacological interventions; cognitive behavioural therapy (CBT) and graded exercise therapy (GET), which have been shown to be very effective in treating CFS. Finally, we discuss CFS in children and adolescents which in recent years, has become more acknowledged. Prevalence and treatment of CFS in children is discussed with special attention being paid to developmental issues.

A Follow-up Study of Chronic Fatigue Syndrome in Children and Adolescents: Symptom Persistence and School Absenteeism

This is a follow-up study of 28 young people aged between 7 and 17 meeting the Oxford criteria for the diagnosis of chronic fatigue syndrome treated in a specialist paediatric/psychiatric service. Retrospective case note analysis revealed a wide range and duration of symptoms together with high levels of school absenteeism prior to the diagnosis. The mean follow-up interval after discharge from the specialist service was 3 years and although most of the young people regarded themselves as fully recovered by this time, improvement was variable and about one third were still experiencing disabling symptoms. The illness had impacted on the education or career plans of all the young people to some extent with 15 experiencing difficulty returning to school. This article highlights the need for early recognition and diagnosis of chronic fatigue syndrome in young people and the importance of continuing paediatric support to reduce symptom persistence in the sensitive recovery period. Maintaining school attendance by close liaison between health and education services both before and after diagnosis and treatment is also vital if long-term morbidity is to be reduced.

Recognizing Pediatric CFS in the Primary Care Practice

Pediatricians and primary care physicians may be uncomfortable diagnosing Chronic Fatigue Syndrome in children because a good diagnostic tool has not been available. Deferring a diagnosis, however, may lead to apprehension, over-utilization of medical resources in a search for validity, a delay in treatment, and possibly inappropriate coping techniques. This case-based article discusses symptoms and signs seen in adolescent patients with CFS, evaluation of suspect cases, and both current and future diagnostic case definitions.

Chronic Fatigue Syndrome in Children and Adolescents

AbstractObjective: An overview of the unique aspects of Chronic Fatigue Syndrome in children and adolescents (CACFS) is herein provided for healthcare professionals who may be called upon to diagnose and/or treat this illness. Young age of onset, puberty, and interactions with peers and the educational system provide greater diagnostic and treatment challenges than found with adult onset CFS.Method: A review of diagnostic procedures and treatment protocols found in the contemporary literature is coupled with the professional experiences of the authors in treating CACFS to delineate the roles and responsibilities of family, healthcare providers and educators in diagnosing, treating and supporting the CACFS patient.Results: Areas discussed include: pathogenesis, patient evaluation, clinical evaluation, laboratory evaluation, treatment options, psychological issues, role of schools, and the roles of primary and tertiary care providers.Conclusion: CACFS can be diagnosed and treated with varying levels of succ...

Handbook of Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) has been recognized as an entity since the 1800s, when it was known as “neurasthenia.” A panel of experts who convened in 1994 to establish a set of diagnostic criteria for CFS described it as a syndrome that includes disabling fatigue, cognitive difficulties, nonrefreshing sleep, and myalgias. Autonomic instability, mental illness, immunologic abnormalities, and swollen lymph nodes are sometimes present in patients with CFS. It frequently coexists with fibromyalgia. The Handbook of Chronic Fatigue Syndrome summarizes the current research and clinical knowledge about this disorder. Chronic fatigue syndrome is largely a “diagnostically homeless” entity. No one medical specialty takes ownership of CFS, and it is not routinely included in medical school and residency curricula. There is much controversy surrounding its diagnosis and even its legitimacy as a medical illness. The differential diagnosis of CFS is large, making its diagnosis difficult. Endocrine, rheumatologic, neurologic, infectious, hematologic, nutritional, metabolic, and psychiatric disorders can mimic or contribute to the disorder. Profound occupational, social, and family problems can also result from the illness. A multisystem approach using the biopsychosocial model is best used in the diagnosis and management of CFS. Part I of the Handbook discusses epidemiology, differential diagnosis, sociocultural issues, immunology, and genetics; the major criteria as well as additional symptoms that constitute the diagnosis of CFS, as established by the panel of experts, are listed. Part II is about the social, individual, and family systems effects of CFS. Part III goes into specifics about the symptomatology of CFS, including sections on pain and fatigue, orthostatic intolerance, and sleep, cardiac, and neuroendo-crine dysfunction. Part IV discusses pain rating scales and other diagnostic instruments. Part V is a large section on treatments and interventions. Comprehensive treatment regimens including medical treatment, exercise, nutrition, and psychotherapy are described. Part VI discusses diagnosis and treatment of CFS in children and adolescents. The editors have succeeded in producing a comprehensive and interesting text. Although this volume, at 794 pages, stretches the definition of “handbook,” readers are rewarded with an exhaustively researched and evidence-based work that should prove to be clinically useful.

Chronic fatigue syndrome in children

Summary Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is a heterogeneous condition that causes significant morbidity in young people. Its cause is unknown with current evidence suggesting that, in mild and moderate cases, cognitive behaviour therapy and/or graded exercise should be the treatment of choice. The majority of adolescents will improve or get better. Further research is required to determine aetiology and optimum management.

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...

Annotation: Chronic Fatigue Syndrome in children and adolescents.

Over the past two decades Chronic Fatigue Syndrome (CFS) of childhood has gained increasing prominence. A number of clinical reports and case-control studies have examined the nature of the disorder, its associations, response to treatment and outcome. A review of publications on childhood CFS was undertaken and reference to work on adult CFS made. Most studies on childhood CFS have been on markedly affected children attending specialist pediatric clinics and very little is known about the condition as it presents in the community or to general medical services. The main symptom is fatigue in association with a variety of physical symptoms and with marked and prolonged functional impairment. CFS is commonly reported as being brought on by acute infections. Co-morbid psychiatric (usually mood) disorders are present in at least a half. Personality problems and health attitudes have been described as possible predisposing and maintaining factors. Clinical reports indicate that family work focused on engagement and on a rehabilitation programme (including graded increasing activity and treatment of psychiatric co-morbidity) can help even the more severely impaired children. Recovery may be expected in over two-thirds. CFS presents as a distinct, markedly impairing disorder of childhood. In its severe form, it is often associated with mood disorders. Further research into milder forms and into the efficacy of different treatment interventions is specially needed.

Thirteen-year follow-up of children and adolescents with chronic fatigue syndrome.

To describe the educational, social, and symptomatic outcome of children and adolescents with chronic fatigue syndrome 13 years after illness onset. Between January 1984 and December 1987, 46 children and adolescents developed an illness suggestive of chronic fatigue syndrome. Follow-up questionnaires were obtained from 35 participants an average of 13 years after illness onset. Data were obtained concerning subsequent medical diagnoses, amount of school missed, presence and severity of current symptoms, and subjective assessment of degree of illness resolution. Of the 35 participants, 24 were female (68.6%) and 11 were male (31.4%). Average age at illness onset was 12.1 years. Eight participants (22.9%) had an acute onset of symptoms, 27 (77.1%) had a gradual onset. No participant received an alternative medical diagnosis that could have explained the symptom complex between illness onset and follow-up. Thirteen participants (37.1%) considered themselves resolved of illness at follow-up; 15 participants (42.9%) considered themselves well but not resolved; 4 (11.4%) considered themselves chronically ill; and 3 (8.6%) considered themselves more ill than during the early years of illness. Correlation with the Medical Outcomes Study Short Form Health Survey was good for current level of symptoms and degree of recovery. Eight participants (22.9%) missed >2 years of school, and 5 of these were still ill at follow-up. Amount of school missed correlated with both illness severity at follow-up and perceived social impact of the illness. These data demonstrate the presence of an illness consistent with the current definition of chronic fatigue syndrome. Eighty percent of children and adolescents affected had a satisfactory outcome from their fatiguing illness, although the majority of these participants had mild to moderate persisting symptoms. Twenty percent of participants remain ill with significant symptoms and activity limitation 13 years after illness onset. Chronic fatigue syndrome in children and adolescents may result in persistent somatic symptoms and disability in a minority of those affected.

Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.

The prevalence of chronic widespread pain in the general population in Israel was comparable with reports from the USA, UK, and Canada. Comorbidity with fibromyalgia (FM) resulted in somatic hyperalgesia in patients with irritable bowel syndrome. One sixth of the subjects with chronic widespread pain in the general population were also found to have a mental disorder. Mechanisms involved in referred pain, temporal summation, muscle hyperalgesia, and muscle pain at rest were attenuated by the N-methyl-D-aspartate (NMDA) antagonist, ketamine, in FM patients. Delayed corticotropin release, after interleukin-6 administration, in FM was shown to be consistent with a defect in hypothalamic corticotropin-releasing hormone neural function. The basal autonomic state of FM patients was characterized by increased sympathetic and decreased parasympathetic systems tones. The severity of functional impairment as assessed by the Medical Outcome Survey Short Form (SF-36) discriminated between patients with widespread pain alone and FM patients. Chronic fatigue syndrome (CFS) occurred in about 0.42% of a random community-based sample of 28,673 adults in Chicago, Illinois. A significant clinical overlap between CFS and FM was reported. Cytokine dysregulation was not found to be a singular or dominant factor in the pathogenesis of CFS. A favorable outcome of CFS in children was reported; two thirds recovered and resumed normal activities. No major therapeutic trials in FM and CFS were reported over the past year.

PSYCHOLOGY SELECTION Clinical Child Psychology and Psychiatry (2000) J. Richards. Chronic fatigue syndrome in children and adolescents. Vol. 5, No. 1, pp. 31–51.

PSYCHOLOGY SELECTION Clinical Child Psychology and Psychiatry (2000) J. Richards. Chronic fatigue syndrome in children and adolescents. Vol. 5, No. 1, pp. 31–51.

Provision of health and education services in school children with chronic fatigue syndrome

ABSTRACTBackground Chronic fatigue syndrome (CFS) in childhood may have a profound effect on a child's life in terms of schooling, social activity and family interaction. Many reports have been based on specialist clinics with little information about CFS in children in the general population and the health and education services provided.Objectives To review cases of CFS in school age children (5–18 years) within the East Suffolk area and determine the health and education services provided.Methods Cases were identified by consultation with the three local health trusts and the education department. Provision of services was determined by review of hospital and school health records. School attendance was determined by postal questionnaire to the school in each case.Results A total of 32 cases were identified, with diagnosis at a peak age of 15 years and 5.8 months as the mean duration of symptoms prior to diagnosis. Some 28 cases were referred by their GP to an acute paediatrician. Only one case was referred to the school medical service. The majority (28/32) received a rehabilitation programme provided by either a child psychiatrist or physiotherapist. Only half the cases were attending school more than half‐time and 10 were not attending school at all and were receiving home tuition. Two of these had never received local paediatric review to confirm the diagnosis or plan management. Follow‐up was highly variable and rarely involved school medical services.Implications A significant number of children with CFS were identified in this semirural school‐age population. Poor involvement of community child services reduced the opportunity for liaison between health and education and made identification of cases difficult. Paediatric review should be mandatory before home tuition is instituted, appropriate referral to psychiatric services encouraged and regular school follow‐up organized to review progress. Close liaison between all health and education services is imperative in planning the provision of services and providing a coherent programme of rehabilitation.

Management of chronic fatigue syndrome in children

Certain areas of child and adolescent mental health generate a degree of polarised debate, both within and outside the profession. Media attention, the development of self-help groups and the Internet lead to the publishing of papers and opinion, which exist alongside peer-reviewed research and evidence-based medicine. Parents reading such material may find it hard to know what advice is best. One area that falls into this category is chronic fatigue syndrome (CFS).

Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.

Fibromyalgia and widespread pain were common in Gulf War veterans with unexplained illness referred to a rheumatology clinic. Increased tenderness was demonstrated in the postmenstrual phase of the cycle compared with the intermenstrual phase in normally cycling women but not in users of oral contraceptives. Patients with fibromyalgia had high levels of symptoms that have been used to define silicone implant-associated syndrome. Tender points were found to be a common transient finding associated with acute infectious mononucleosis, but fibromyalgia was an unusual long-term outcome. The common association of fibromyalgia with other rheumatic and systemic illnesses was further explored. A preliminary study revealed a possible linkage of fibromyalgia to the HLA region. Patients with fibromyalgia were found to have an impaired ability to activate the hypothalamic pituitary portion of the hypothalamic pituitary adrenal axis as well as the sympathoadrenal system, leading to reduced corticotropin and epinephrine response to hypoglycemia. Much interest has been expressed in the literature on the possible role of autonomic dysfunction in the development or exacerbation of fatigue and other symptoms in chronic fatigue syndrome. Mycoplasma genus and mycoplasma fermentans were detected by polymerase chain reaction in patients with chronic fatigue syndrome. It was reported that myofascial temporomandibular disorder does not run in families. No major therapeutic trials in fibromyalgia, chronic fatigue syndrome, or myofascial pain syndrome were reported over the past year. The effectiveness of cognitive behavioral therapy and behavior therapy for chronic pain in adults was emphasized. A favorable outcome of fibromyalgia and chronic fatigue syndrome in children and adolescents was reported.