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Annotation: Chronic Fatigue Syndrome in children and adolescents
M Elena Garralda1, Luiza Rangel
1Academic Unit of Child and Adolescent Psychiatry, Imperial College School of Medicine, London, UK. e.garralda@ic.ac.uk
Insights
Childhood Chronic Fatigue Syndrome (CFS) is a significant disorder causing prolonged functional impairment. Early intervention including rehabilitation and treatment of co-occurring mood disorders can lead to recovery in most cases.
Area of Science:
- Pediatric Medicine
- Neurology
- Psychiatry
Background:
- Childhood Chronic Fatigue Syndrome (CFS) has gained increasing recognition over the past two decades.
- Numerous clinical reports and case-control studies have investigated its nature, associations, treatment response, and outcomes.
Purpose of the Study:
- To review existing literature on childhood CFS.
- To identify knowledge gaps, particularly regarding community-based presentations and general medical service encounters.
Main Methods:
- A comprehensive review of publications on childhood CFS was conducted.
- Relevant studies on adult CFS were also referenced to provide context.
Main Results:
- The primary symptom of childhood CFS is fatigue, accompanied by physical symptoms and significant functional impairment.
- Acute infections frequently trigger CFS, which is often comorbid with mood disorders (in at least 50% of cases).
- Family-centered rehabilitation programs, including graded activity and psychiatric comorbidity treatment, show promise for severely affected children, with over two-thirds expected to recover.
Conclusions:
- Childhood CFS is a distinct and severely impairing condition.
- Severe forms are frequently associated with mood disorders.
- Further research is needed on milder CFS presentations and the effectiveness of various treatment interventions.
Background:
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.
Method:
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.
Results:
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.
Conclusions:
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.