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Chronic fatigue syndrome and other fatiguing illnesses in adolescents: A population-based study.

Jones JF, Nisenbaum R, Solomon L, Reyes M, Reeves WC.
Chronic fatigue syndrome and other fatiguing illnesses in adolescents: A population-based study.
Journal of Adolescent Health 35:34-40, 2004.

Summary

Chronic fatigue syndrome (CFS) is an uncommon illness in children, yet in those affected, the effects are particularly devastating. Fatigue affects about 20% of pediatric tertiary care patients, is most common among adolescents (ages 12-17 years), and is often considered as part of a prolonged infection or post-infectious state. Most reports of CFS in adolescents have described cases identified from clinic settings and do not reflect occurrence of the illness in the general adolescent population. This paper reports 138 fatigued adolescents identified in a population-based study of CFS in Wichita, Kansas. Contrary to our expectations, we could not confirm CFS in any of the children studied. This substantiates previous findings and the upper bound for prevalence of CFS in adolescents is about 50 per 100,000, which is considerably lower than the prevalence among adults (235 per 100,000). Although CFS is uncommon in adolescents, findings from our study indicate the need for careful medical assessment of adolescents presenting to health care professionals for evaluation and care.

Abstract

Purpose: To estimate the prevalence of chronic fatigue syndrome (CFS) and describe characteristics of other fatiguing illnesses in adolescents (ages 12 through 17 years).

Methods: We conducted a random-digit-dialing survey of the residents of Wichita, Kansas. Adults identified fatigued adolescents in the household and answered questions relating to the child's health. Selected adolescents were invited to attend a clinic with a parent/guardian. Following clinical evaluation they were classified as CFS or another fatigue state as defined in the 1994 CFS definition. Annual telephone interviews and clinical evaluations monitored subjects' fatigue status. Data were analyzed using the Kruskal-Wallis test, the Mantel-Haenszel test, and the exact McNemar's test.

Results: The survey contacted 34,018 households with 90,316 residents. Of 8,586 adolescents, 138 had fatigue for ³ 1 month and most (107 or 78%) had chronic fatigue ( ³ 6 months) at some point during the 3 year follow-up. Twenty-eight had exclusionary diagnoses. Thirty-one were considered to have a CFS-like illness and were invited for clinical evaluation. Eleven agreed to participate and none met the CFS case definition. The baseline weighted prevalence of CFS-like illness was 338 per 100,000. Significant differences existed between parental and adolescents' descriptions of illness.

Conclusions: The prevalence of CFS among adolescents was considerably lower than among adults. Evaluation of CFS in adolescents must consider both parent and patient perception of fatigue and other illnesses that might explain the symptom complex.

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