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Arch Dis Child. 2017 Jun;102(6):522-528. doi: 10.1136/archdischild-2016-311198. Epub 2017 Jan 19.

Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents.

Author information

1
Centre for Child and Adolescent Health, University of Bristol, Bristol, UK.
2
School of Social & Community Medicine, University of Bristol, Bristol, UK.
3
CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
4
Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK.

Abstract

OBJECTIVE:

Little is known about persistence of or recovery from chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adolescents. Previous studies have small sample sizes, short follow-up or have focused on fatigue rather than CFS/ME or, equivalently, chronic fatigue, which is disabling. This work aimed to describe the epidemiology and natural course of CFS/ME in adolescents aged 13-18 years.

DESIGN:

Longitudinal follow-up of adolescents enrolled in the Avon Longitudinal Study of Parents and Children.

SETTING:

Avon, UK.

PARTICIPANTS:

We identified adolescents who had disabling fatigue of >6 months duration without a known cause at ages 13, 16 and 18 years. We use the term 'chronic disabling fatigue' (CDF) because CFS/ME was not verified by clinical diagnosis. We used multiple imputation to obtain unbiased estimates of prevalence and persistence.

RESULTS:

The estimated prevalence of CDF was 1.47% (95% CI 1.05% to 1.89%) at age 13, 2.22% (1.67% to 2.78%) at age 16 and 2.99% (2.24% to 3.75%) at age 18. Among adolescents with CDF of 6 months duration at 13 years 75.3% (64.0% to 86.6%) were not classified as such at age 16. Similar change was observed between 16 and 18 years (75.0% (62.8% to 87.2%)). Of those with CDF at age 13, 8.02% (0.61% to 15.4%) presented with CDF throughout the duration of adolescence.

CONCLUSIONS:

The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years.

KEYWORDS:

ALSPAC; Adolescent Health; CFS/ME; Chronic Fatigue Syndrome; Longitudinal

PMID:
28104625
PMCID:
PMC5466925
DOI:
10.1136/archdischild-2016-311198
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Competing interests: TN is funded by an MRC research grant (MR/K020269/1); SC is funded by an NIHR Postdoctoral Fellowship (PDF-2013-06-011); EC is funded by an NIHR Senior Research Fellowship (SRF-2013-06-013); JH is funded by a number of grants, mainly the MRC and Kate Tilling is HEFCE-funded. JS is funded by National Institute for Health Research Senior Investigator award NF-SI-0611-10168. This study was supported by an MRC research grant (MR/K020269/1). EC is a medical advisor for the Association of Young People with ME (AYME) and the Sussex & Kent ME/CFS Society.

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