Course & outcome of chronic fatigue in children & adolescents

PURPOSE: To describe the epidemiology, symptoms, and
psychosocial characteristics of children and adolescents
evaluated in a chronic fatigue program and determine the
course and outcome of the syndrome in these patients.

METHODS: During the summer of 1994, chart review was
performed for the 58 patients evaluated between 1990 and 1994
and a telephone follow-up was conducted with 42 of the 58 families.
Patients were predominantly female (71%) and white (94%), with
50% between the ages of 7 and 14 years and 50% between the
ages of 15 and 21 years (mean age 14.6 years).

RESULTS: At time of presentation, 50% of patients had been
fatigued for 1 to 6 months and 50% had been fatigued for 7 to 36
months. Sixty percent indicated the fatigue had begun with an acute
illness and 60% had a history of allergies. Most commonly reported
symptoms were fatigue (100%), headache (74%), sore throat
(59%), abdominal pain (48%), fever (36%), and difficulties
with concentration and/or memory (33%). Most patients had a
worsening of school performance and a decrease in social
activities. On follow-up, there was significant improvement in
many patients during the summer after the first visit, with
continued improvement in most patients during the second and
third years. At time of the follow-up telephone call, 43% of
families considered their child "cured" and 52% considered
their child "improved," whereas only 5% considered their child
to be "the same." Statistical analyses demonstrated no
demographic or clinical factors that distinguished between
those who did or did not participate in the follow-up study,
or between those who did or did not do well on follow-up.

CONCLUSIONS: These data demonstrate that children and
adolescents with chronic fatigue have a syndrome that is
similar to that described in adults, but that the syndrome
differs in several ways, most specifically, presentation
earlier in the course of the illness and a more optimistic
outcome.

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