Full Title: Depression and anxiety in children with CFS/ME: cause or effect?
Authors: Helen Bould1, Glyn Lewis2, Alan Emond1, Esther Crawley1
Publication: Archive of Disease in Childhood
Publication Date: 26th July 2010
1Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
2Department of Academic Psychiatry, University of Bristol, Bristol, UK
Professor Alan Emond, Centre for Child and Adolescent Health, University of Bristol, Hampton House, Cotham Hill, Bristol BS6 6JS, UK; email@example.com
Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a common (0.19–2%) and disabling condition in children and young people, with over 50% of affected children and young people bed bound at some stage and a mean time off school of 1 academic year. The importance of CFS/ME has been highlighted by both the Chief Medical Officer's report and the National Institute for Health and Clinical Excellence (NICE) guidelines.
A variety of case definitions for CFS/ME exist (box 1), and studies, including those reviewed here, often use different definitions, particularly around the duration of symptoms. It is not clear whether the different case definitions have different implications for aetiology or prognosis. Paediatric CFS/ME is defined in the Royal College of Paediatrics and Child Health guidelines as “generalised fatigue persisting after routine tests and investigations have failed to identify an obvious underlying cause”. The NICE recommended that the fatigue should have lasted 3 months before a diagnosis is made and highlighted the fact that the fatigue must be disabling and was likely to occur in the presence of one other symptom (box 1). There is a philosophical discussion to be had on how diagnoses are made, particularly with diagnoses where no underlying pathogen has been identified, but it can be argued that “delineation of a syndrome is the first step towards elucidation of the chain of causation and redefinition of the whole group or subgroups within it”.
Box 1 Definitions for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) in children and young people
Royal College of Paediatrics and Child Health definition of chronic fatigue syndrome or myalgic encephalomyelitis
”Generalised fatigue persisting after routine tests and investigations have failed to identify an obvious underlying cause”
National Institute for Health and Clinical Excellence 2007 guidelines7
Fatigue with all of the following features:
New or had a specific onset …