Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents
Open accessAbstract
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.
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- Authors
- Norris, T., Collin, S. M., Tilling, K., Nuevo, R., Stansfeld, S. A., Sterne, J. A., Heron, J., & Crawley, E.
- Affiliations
- University of Bristol (GB)
- Instituto de Salud Carlos III (ES)
- Queen Mary University of London (GB)
- Corresponding author
- Crawley, Esther
- ORCID
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2017-01-19
- Volume
- 102
- Issue
- 6
- Pages
- 522-528
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- PMC
- PMC5466925
- OpenAlex
- W2574430848
- Cited by
- 29
- References
- 41
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 4 · 2019: 8 · 2018: 6 · 2017: 2
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Archives of Disease in Childhood (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by)
- HighWire Press Open Archive (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- Funders
- Medical Research Council (MR/K020269/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Keywords
- chronic fatigue syndrome, adolescents, natural history (disease), disease persistence, recovery, prevalence, longitudinal follow-up, Avon Longitudinal Study of Parents and Children
- MeSH terms
- Adolescent, Educational Status, England, Female, Follow-Up Studies, Humans, Male, Prognosis, Time Factors, Fatigue Syndrome, Chronic, Prevalence, Sex Distribution
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