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Clinical Practice: Chronic fatigue syndrome

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Abstract

The diagnosis chronic fatigue syndrome (CFS) was conceptualized in the mid-1980s. It is a clinically defined condition characterized by severe and disabling new onset fatigue with at least four additional symptoms: impaired memory or concentration, sore throat, tender cervical or axillary lymph nodes, muscle pain, multi-joint pain, new headaches, unrefreshing sleep or post-exertion malaise. Chronic fatigue syndrome in adolescents is a rare condition compared to symptomatic fatigue. The estimated prevalence of adolescent CFS ranges between 0.11 and 1.29 % in Dutch, British, and US populations. Diagnosis of the chronic fatigue syndrome is established through exclusion of other medical and psychiatric causes of chronic fatiguing illness. Taking a full clinical history and a full physical examination are therefore vital. In adolescence, CFS is associated with considerable school absence with long-term detrimental effects on academic and social development. One of the most successful potential treatments for adolescents with CFS is cognitive behavioural therapy, which has been shown to be effective after 6 months in two thirds of the adolescents with CFS. This treatment effect sustains at 2–3-year follow-up. In conclusion, the diagnosis CFS should be considered in any adolescent patient with severe disabling long-lasting fatigue. Cognitive behavioural therapy is effective in 60–70 % of the patients. Prompt diagnosis favours the prognosis.

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Abbreviations

CBT:

Cognitive behavioural therapy

CDC:

Centre for Disease Control and Prevention

CFS:

Chronic fatigue syndrome

UMC Utrecht:

University Medical Centre Utrecht

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Acknowledgments

Charlotte L. Werker is a medical student participating in the Honours program of the Faculty of Medicine, UMC Utrecht.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Pediatrics, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands

    Charlotte L. Werker, Sanne L. Nijhof & Elise M. van de Putte

  2. Department of Pediatrics, University Medical Centre Utrecht, Office KE 04.133.1, Postbox 85090, 3508 AB, Utrecht, The Netherlands

    Elise M. van de Putte

Authors
  1. Charlotte L. Werker
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  2. Sanne L. Nijhof
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  3. Elise M. van de Putte
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Correspondence to Elise M. van de Putte.

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Werker, C.L., Nijhof, S.L. & van de Putte, E.M. Clinical Practice: Chronic fatigue syndrome. Eur J Pediatr 172, 1293–1298 (2013). https://doi.org/10.1007/s00431-013-2058-8

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  • DOI: https://doi.org/10.1007/s00431-013-2058-8

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