scholarly journals The course of severe chronic fatigue syndrome in childhood

2000 ◽  
Vol 93 (3) ◽  
pp. 129-134 ◽  
Author(s):  
L Rangel ◽  
M E Garralda ◽  
M Levin ◽  
H Roberts
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Bed Rest ◽  
Chronic Fatigue ◽  
Prognostic Indicators ◽  
Illness Onset ◽  
Fatigue Syndrome ◽  
School Absence ◽  
Duration Of Illness ◽  
Severe Fatigue ◽  
Recovery Assessment

Summary Little has been reported on prognostic indicators in children with chronic fatigue syndrome (CFS). We used interviews with children and parents, a mean of 45.5 months after illness onset, to follow up 25 cases of CFS referred to tertiary paediatric psychiatric clinics. At its worst, the illness had been markedly handicapping (prolonged bed-rest and school absence in two-thirds); mean time out of school was one academic year. Two-thirds, however, had recovered and resumed normal activities—mean duration of illness to recovery/assessment 38 months—and none had developed other medical conditions. Recovery was associated with specific physical triggers to the illness, with start of illness in the autumn school term and with higher socioeconomic status. Severe fatigue states in children can cause serious and longlasting handicap but most children recover.

Prevalence of ADHD in chronic fatigue syndrome

2011 ◽  
Vol 26 (S2) ◽  
pp. 1574-1574
Author(s):  
N. Sáez Francàs ◽  
J. Alegre ◽  
N. Calvo Piñero ◽  
J.A. Ramos Quiroga ◽  
E. Ruiz ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Rating Scale ◽  
Chronic Fatigue ◽  
Diagnostic Interview ◽  
Initial Sample ◽  
Hyperactivity Disorder ◽  
Fatigue Syndrome ◽  
Severe Fatigue ◽  
Severe Psychopathology ◽  
The Relationship

IntroductionChronic Fatigue Syndrome (CFS) is characterized by severe fatigue associated with pain, sleep disturbance, attentional impairment and headaches. Evidence points towards a prominent role for Central Nervous System in its pathogenesis, and alterations in serotoninergic and dopaminergic neurotransmission have been described.Attention-deficit Hyperactivity Disorder (ADHD) courses with inattention, impulsivity, and hyperactivity. It affects children and persists into adulthood in 50% of patients. Dopamine transporter abnormalities lead to impaired neurotransmission of catecholaminergic frontal-subcortical-cerebellar circuits.ObjectivesTo describe the prevalence of ADHD in a sample of CFS patients, and the clinical implications of the association.AimsTo study the relationship between CFS and ADHD.MethodsThe initial sample consisted of 142 patients, of whom 9 were excluded because of severe psychopathology or incomplete evaluation. All the patients (age 49 ± 87; 94,7 women) received CFS diagnoses according to Fukuda criteria. ADHD was assessed with a diagnostic interview (CAADID), ADHD Rating Scale and the scale WURS, for childhood diagnose. The scales FIS-40, HAD, STAI and Pluthik Risk of Suicide (RS) were administrated.Results38 patients (28,8%) were diagnosed of childhood ADHD (4 combined, 22 hyperactive-impulsive, 12 inattentive) and persisted into adulthood in 28 (21,1%; 5 combined, 4 hyperactive-impulsive, 19 inattentive). There were no differences in Fukuda criteria profile and FIS-40 between groups. ADHD patients scored higher in HAD-Anxiety (9,88 ± 4,82 vs. 12,57 ± 3,49; p = 0,007), HAD-Depression (9,69 ± 4,84 vs. 12,04 ± 4,53; p = 0,023), STAI-E (30,55 ± 14,53 vs. 38,41 ± 11,35; p = 0,012), and RS (6,13 ± 3,48 vs. 8,49 ± 3,07; p = 0,002).ConclusionsADHD is frequent in CFS patients and it is associated with more severe clinical profile.

scholarly journals Chronic fatigue syndrome in the routine hematology practice

2020 ◽  
Vol 11 (4) ◽  
pp. 47-54
Author(s):  
Vsevolod G. V.G.Potapenko ◽  
Marina F. Ballyuzek
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Clinical Signs ◽  
Chronic Fatigue ◽  
Deficiency Anemia ◽  
Fatigue Syndrome ◽  
Severe Fatigue ◽  
Iron Deficient ◽  
Initial Symptoms ◽  
Median Level ◽  
The Difference

Purpose. Presentation of clinical signs and laboratory profiles of the patients with chronic fatigue syndrome, and comparison of their symptoms with those of the patients with iron deficiency anemia. Materials and methods. Retrospective analysis of the patients symptoms referred to the hematologist outpatient clinic during the period between January 2016 and December 2018. Results. There were 560 patients(162 males and 398 females) referred for a primary consultation by a hematologist. Median age was 52.5 (1894) years. The unexplained fatigue was reported by 27 (4.8%) patients (1 male and 26 females), median age 41 (2466) years. Diagnosis chronic fatigue syndrome (CFS) was confirmed based on the criteria in 17 (63%) patients. 10 patients (47%) with symptoms partially meeting the criteria were diagnosed idiopathic fatigue syndrome (SIF). Half of the patients connected the onset of the diseases with emotional trauma (family issues etc.). The prevailing complaints (30%) were represented by: prolonged fatigue, mild memory impairment and distraction, arthralgia and insomnia. The most frequent reason to see a hematologist was fatigue and borderline changes in the blood tests. Five patients with CFS and 2 patients with SIF were known to have previously diagnosed iron deficient anemia (IDA). Median level of hemoglobin in the patients with severe fatigue and IDA was 10.7 (8.411.7) g/dl. Median follow up duration was 28 (640) months. In the observed group (n = 23) 17% of the patients (n = 4) showed spontaneous improvement. The rest of the patients had reported no changes. The comparison group (n = 64) included the patients with IDA. Most of them (n = 38) did not report fatigue as their initial symptoms (median level of hemoglobin was 9.35 (5.511.9) g/dl). Twenty six patients reported fatigue; median level of hemoglobin was 8.15 (5.911.7) g/dl. The difference between the hemoglobin levels in two groups was significant (р 0.05). However, there was no correlation between the level of hemoglobin and fatigue in the patients with CFS and SIF. The correlation was found in the patients with CFS and SIF between fatigue and patients perception. Conclusion. The main symptoms accompanying CFS are fatigue and other non-specific symptoms which are often related to patients emotional status. Considering CFS as a differential diagnosis when dealing with fatigue is essential.

scholarly journals Chronic Fatigue Syndrome: Cognitive, Behavioural and Emotional Processing Vulnerability Factors

2017 ◽  
Vol 45 (2) ◽  
pp. 156-169 ◽  
Author(s):  
Samantha K. Brooks ◽  
Trudie Chalder ◽  
Katharine A. Rimes
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Emotional Processing ◽  
Chronic Fatigue ◽  
Psychological Characteristics ◽  
Personality Factors ◽  
Healthy Individuals ◽  
Illness Onset ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Current Characteristics

Background: Cognitive-behavioural models of chronic fatigue syndrome (CFS) suggest that personality factors such as perfectionism and high moral standards may contribute to the development of CFS. Aims: To investigate cognitive, behavioural and emotional processing risk factors for CFS. Method: CFS patients (n = 67) at a UK specialist clinic completed questionnaires about psychological characteristics both currently and retrospectively (6 months pre-CFS onset). Responses were compared with those of healthy individuals (n = 73) who rated their current characteristics. Forty-four relatives retrospectively rated the pre-morbid psychological characteristics of the CFS participants. Results: CFS patients showed similar levels of current perfectionism to controls, though higher pre-morbid perfectionism. CFS patients showed greater self-sacrificial beliefs and more unhelpful beliefs about experiencing and expressing negative emotions, both currently but more markedly prior to onset. In the 6 months pre-illness onset, CFS patients showed more disruption to their primary goal and greater general stress than controls. Ratings of pre-morbid psychological characteristics by relatives were consistent with patients’ self-reports. The extent of overinvestment in one goal was significantly associated with fatigue. Conclusions: Perfectionism, self-sacrificial tendencies, unhelpful beliefs about emotions, and perceived stress may be present to a greater extent pre-morbidly in CFS patients compared with healthy individuals.

scholarly journals Understanding Muscle Dysfunction in Chronic Fatigue Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Gina Rutherford ◽  
Philip Manning ◽  
Julia L. Newton
Keyword(s):  
Skeletal Muscle ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Muscle Dysfunction ◽  
Biochemical Abnormality ◽  
Fatigue Syndrome ◽  
Acid Clearance ◽  
Severe Fatigue ◽  
Show Evidence ◽  
Accompanying Symptoms

Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level.Methods.Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis.Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction.Discussion.Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

scholarly journals The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model

2019 ◽  
Vol 6 (1) ◽  
pp. 205510291983890 ◽  
Author(s):  
Keith Geraghty ◽  
Leonard Jason ◽  
Madison Sunnquist ◽  
David Tuller ◽  
Charlotte Blease ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Irrational Beliefs ◽  
Chronic Fatigue ◽  
Primary Treatment ◽  
Behavioural Therapy ◽  
Illness Onset ◽  
Fatigue Syndrome ◽  
Behavioural Model ◽  
Cognitive Behavioural ◽  
Change Beliefs

Chronic fatigue syndrome/myalgic encephalomyelitis is a debilitating illness that greatly impacts the lives of sufferers. A cognitive behavioural model attempts to explain illness onset and continuance with a hypothesis that the illness is perpetuated by patients’ irrational beliefs and avoidance behaviours. This theory underpins the promotion of cognitive behavioural therapy, a treatment that aims to change beliefs and behaviours. This article reports on a detailed review of the cognitive behavioural model. Our review finds that the model lacks high-quality evidential support, conflicts with accounts given by most patients and fails to account for accumulating biological evidence of pathological and physiological abnormalities found in patients. There is little scientific credibility in the claim that psycho-behavioural therapies are a primary treatment for this illness.

scholarly journals Fatigue Scales and Chronic Fatigue Syndrome: Issues of Sensitivity and Specificity

2011 ◽  
Vol 31 (1) ◽  
Author(s):  
Leonard Jason ◽  
Jason Meredyth Evans ◽  
Molly Brown ◽  
Nicole Porter ◽  
Abigail Brown ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Chronic Fatigue ◽  
Roc Curve Analysis ◽  
Fatigue Syndrome ◽  
Specificity And Sensitivity ◽  
Severe Fatigue ◽  
Fatigue Severity ◽  
Extreme Care

<p>Few studies have explored issues of sensitivity and specificity for using the fatigue construct to identify patients meeting chronic fatigue syndrome (CFS) criteria. In this article, we examine the sensitivity and specificity of several fatigue scales that have attempted to define severe fatigue within CFS. Using Receiver Operating Characteristic (ROC) curve analysis, we found most scales and sub-scales had either significant specificity and/or sensitivity problems. However, the post-exertional subscale of the ME/CFS Fatigue Types Questionnaire (Jason, Jessen, et al., 2009) was the most promising in terms of specificity and sensitivity. Among the more traditional fatigue scales, Krupp, LaRocca, Muir-Nash, and Steinberg’s (1989) Fatigue Severity Scale had the best ability to differentiate CFS from healthy controls. Selecting questions, scales and cut off points to measure fatigue must be done with extreme care in order to successfully identify CFS cases.</p>

scholarly journals Chronic fatigue syndrome: comments on deconditioning, blood volume and resulting cardiac function

2009 ◽  
Vol 118 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Julian M. Stewart
Keyword(s):  
Cardiac Output ◽  
Chronic Fatigue Syndrome ◽  
Stroke Volume ◽  
Blood Volume ◽  
Sedentary Lifestyle ◽  
Orthostatic Intolerance ◽  
Bed Rest ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
Cardiac Stroke Volume

Cardiovascular and autonomic dysfunction have been suggested to underlie the symptoms accompanying CFS (chronic fatigue syndrome). In the present issue of Clinical Science, Hurwitz and co-workers have investigated whether deficits were present in cardiac output and blood volume in a cohort of patients with CFS and if these were linked to illness severity and sedentary lifestyle. The results clearly demonstrate reduced cardiac stroke volume and cardiac output in more severely afflicted patients with CFS, which is primarily attributable to a measurable reduction in blood volume. Similar findings are observed in microgravity and bed rest deconditioning, in forms of orthostatic intolerance and, to a lesser extent, in sedentary people. The circulatory consequences of reduced cardiac output may help to account for many of the findings of the syndrome.

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