An overview of pediatric chronic fatigue syndrome- a scoping review 10.55131/jphd/2025/230221
Article Sidebar
Main Article Content
Abstract
A clinical disorder known as chronic fatigue syndrome (CFS) is characterized by severe fatigue causing physical and psychosocial limitations. CFS has an unclear etiology and prognosis. This study examines the empirical literature comparing the prevalence, risk factors, impact on everyday life, and management associated with pediatric CFS. Investigators searched Scopus and PubMed databases utilizing the key terms Pediatric CFS, CFS/ME, Prevalence, Incidence, Epidemiology, Risk Factors, Genetic predispositions, Psychosocial factors, Impact, Quality of life, Impairment, Management, Intervention, and Treatment. A preliminary literature search found 1,860 articles. The inclusion criteria were articles published in English from 1994 onwards, focusing on pediatric chronic fatigue syndrome. After screening based on inclusion criteria, objectives, and language, 24 articles were selected for review. The analysis showed significant regional and global differences in the prevalence of pediatric CFS. Genetic characteristics, premorbid childhood difficulties, history of infectious disease, maternal prenatal conditions, and socio-economic status have been identified as risk factors for CFS. Children experience disruption and losses in physical, social, and psychological aspects of life because of CFS. There is currently no approved treatment for CFS in the pediatric population, even though some community-based and psychosocial intervention shows improvements in symptoms. The study underscores the need for standardized diagnostic criteria. It emphasizes the multifactorial nature of CFS onset, urging further research to elucidate causal pathways. Additionally, it stresses the significant impact of CFS on children’s lives calling for comprehensive treatment strategies.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
NICE. Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management, NICE. 2007 [Internet]. [Cited 2024 Apr 17]. Available from: https://www.nice.org.uk/guidance/ cg53
NICE. Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, NICE. 2021 [Internet]. [Cited 2024 Apr 23]. Available from: https://www. nice.org.uk/guidance/ng206
Baker R, Shaw EJ. Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance. BMJ. 2007;335(7617):446–8. doi: 10.1136/ bmj.39302.509005
Sapra A, Bhandari P. Chronic Fatigue Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024 [Cited 2024 Sep 18]. Available from: http://www.ncbi.nlm.nih.gov/ books/NBK557676/
Crawley E. Pediatric chronic fatigue syndrome: current perspectives. Pediatr Health Med Ther. 2018;9:27–33. doi: 10.2147/PHMT.S126253
Collin SM, Nuevo R, van de Putte EM, Nijhof SL, Crawley E. Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts. BMJ Open. 2015;5(10):e008830. doi: 10.1136/ bmjopen-2015-008830
Carruthers BM, Jain AK, De Meirleir KL, Peterson DL, Klimas NG, Lerner AM, et al. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols. J Chronic Fatigue Syndr. 2003; 11(1):7–115.
Bell DS, Jordan K, Robinson M. Thirteen-year follow-up of children and adolescents with chronic fatigue syndrome. Pediatrics. 2001;107(5): 994–8. doi: 10.1542/peds.107.5.994
Kennedy G, Underwood C, Belch JJ. Physical and functional impact of chronic fatigue syndrome/myalgic encephalomyelitis in childhood. Pediatrics. 2010;125(6):e1324-1330. doi: 10.1542/peds.2009-2644
Leonard A, Jason. A Pediatric Case Definition for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome. 2006 [Internet]. [Cited 2024 Apr 23]. Available from: https://www. researchgate.net/publication/228640546_A_Pediatric_Case_Definition_for_Myalgic_Encephalomyelitis_and_Chronic_Fatigue_Syndrome
Gaunt DM, Brigden A, Harris SRS, Hollingworth W, Jago R, Solomon-Moore E, et al. Graded exercise therapy compared to activity management for paediatric chronic fatigue syndrome/ myalgic encephalomyelitis: pragmatic randomized controlled trial. Eur J Pediatr. 2024;183(5):2343–51. doi: 10.1007/s00431-024-05458-x
Rowe PC, Underhill RA, Friedman KJ, Gurwitt A, Medow MS, Schwartz MS, et al. Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer. Front Pediatr. 2017 [Internet]. [Cited 2024 Oct 6]. Available from: https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2017.00121/full
Royston AP, Rai M, Brigden A, Burge S, Segal TY, Crawley EM. Severe myalgic encephalomyelitis/chronic fatigue syndrome in children and young people: a British Paediatric Surveillance Unit study. Arch Dis Child. 2023;108(3):230–235. doi: 10.1136/archdischild-2022-324319
Royston AP, Burge S, Idini I, Brigden A, Pike KC. Management of severe ME/CFS in children and young people in the UK: a British Paediatric Surveillance Unit study. BMJ Paediatr Open. 2024;8(1):e002436. doi: 10.1136/bmjpo-2023-002436
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
JBI Critical Appraisal Tools. JBI [Internet]. [Cited 2024 Sep 20]. Available from: https://jbi.global/ critical-appraisal-tools
Study Quality Assessment Tools. NHLBI, NIH [Internet]. [Cited 2024 Sep 20]. Available from: https:// www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
Jason LA, Katz BZ, Sunnquist M, Torres C, Cotler J, Bhatia S. The Prevalence of Pediatric Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in a Community‑Based Sample. Child Youth Care Forum. 2020;49(4):563–579. doi: 10.1007/ s10566-019-09543-3
Nijhof SL, Maijer K, Bleijenberg G, Uiterwaal CSPM, Kimpen JLL, van de Putte EM. Adolescent chronic fatigue syndrome: prevalence, incidence, and morbidity. Pediatrics. 2011;127(5): e1169-1175. doi: 10.1542/peds.2010-1147
Crawley E, Hughes R, Northstone K, Tilling K, Emond A, Sterne JAC. Chronic disabling fatigue at age 13 and association with family adversity. Pediatrics. 2012;130(1):e71-79. doi: 10.1542/peds.2011-2587
Collin SM, Tilling K, Joinson C, Rimes KA, Pearson RM, Hughes RA, et al. Maternal and childhood psychological factors predict chronic disabling fatigue at age 13 years. J Adolesc Health Off Publ Soc Adolesc Med. 2015;56(2): 181–7. doi: 10.1016/j.jadohealth. 2014.09.002
Viner RM, Clark C, Taylor SJ, Bhui K, Klineberg E, Head J, et al. Longitudinal risk factors for persistent fatigue in adolescents. Arch Pediatr Adolesc Med. 2008;162(5):469–75. doi: 10.1001/ archpedi.162.5.469
Crawley E, Sterne JA. Association between school absence and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy. Arch Dis Child. 2009;94(10):752-6. doi: 10.1136/adc.2008.143537
Farmer AE, Scourfield J, Martin N, Cardno A, McGuffin P. Is disabling fatigue in childhood influenced by genes? Psychol Med. 1999;29(2):279–82. doi: 10.1017/s0033291798008095
Josev EK, Jackson ML, Bei B, Trinder J, Harvey A, Clarke C, et al. Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2017;13(9):1057–66. doi: 10.5664/jcsm.6722
Sankey A, Hill CM, Brown J, Quinn L, Fletcher A. A follow-up study of chronic fatigue syndrome in children and adolescents: symptom persistence and school absenteeism. Clin Child Psychol Psychiatry. 2006;11(1):126–38. doi: 10.1177/1359104506059133
Rangel L, Garralda ME, Levin M, Roberts H. The course of severe chronic fatigue syndrome in childhood. J R Soc Med. 2000;93(3):129-34. doi: 10.1177/ 014107680009300306
Fisher H, Crawley E. Why do young people with CFS/ME feel anxious? A qualitative study. Clin Child Psychol Psychiatry. 2013;18(4):556-73. doi: 10.1177/1359104512460862
Al-Haggar MS, Al-Naggar ZA, Abdel-Salam MA. Biofeedback and cognitive behavioral therapy for Egyptian adolescents suffering from chronic fatigue syndrome. J Pediatr Neurol. 2006;4(3):161–9.
Lim A, Lubitz L. Chronic fatigue syndrome: successful outcome of an intensive inpatient programme. J Paediatr Child Health. 2002 Jun;38(3):295–9. doi: 10.1046/j.1440-1754.2002.00786.x
Ashby B, Wright B, Jordan J. Chronic Fatigue Syndrome: An Evaluation of a Community Based Management Programme for Adolescents and their Families. Child Adolesc Ment Health. 2006;11(1):13-18. doi: 10.1111/j.1475-3588.2005.00383.x
Gordon BA, Knapman LM, Lubitz L. Graduated exercise training and progressive resistance training in adolescents with chronic fatigue syndrome: a randomized controlled pilot study. Clin Rehabil. 2010;24(12): 1072-9. doi: 10.1177/0269215510371 429
Gordon B, Lubitz L. Promising outcomes of an adolescent chronic fatigue syndrome inpatient programme. J Paediatr Child Health. 2009;45(5): 286–90. doi: 10.1111/j.1440-1754. 2009.01493.x
Lloyd S, Chalder T, Sallis HM, Rimes KA. Telephone-based guided self-help for adolescents with chronic fatigue syndrome: A non-randomised cohort study. Behav Res Ther. 2012;50(5): 304–12. doi: 10.1016/j.brat.2012. 02.014
Nijhof SL, Priesterbach LP, Uiterwaal CSPM, Bleijenberg G, Kimpen JLL, van de Putte EM. Internet-based therapy for adolescents with chronic fatigue syndrome: long-term follow-up. Pediatrics. 2013;131(6):e1788-1795. doi: 10.1542/peds.2012-2007
Viner R, Gregorowski A, Wine C, Bladen M, Fisher D, Miller M, et al. Outpatient rehabilitative treatment of chronic fatigue syndrome (CFS/ME). Arch Dis Child. 2004;89(7):615–9. doi: 10.1136/adc.2003.035154
Haines LC, Saidi G, Cooke RWI. Prevalence of severe fatigue in primary care. Arch Dis Child. 2005 Apr;90(4): 367–8. doi: 10.1136/adc.2003.039917
Collin SM, Norris T, Nuevo R, Tilling K, Joinson C, Sterne JA, et al. Chronic Fatigue Syndrome at Age 16 Years. Pediatrics. 2016;137(2):e20153434. doi: 10.1542/peds.2015-3434
Bakken IJ, Tveito K, Gunnes N, Ghaderi S, Stoltenberg C, Trogstad L, et al. Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012. BMC Med. 2014;12:167. doi: 10.1186/s12916-014-0167-5
van de Putte EM, van Doornen LJ, Engelbert RH, Kuis W, Kimpen JL, Uiterwaal CSP. Mirrored symptoms in mother and child with chronic fatigue syndrome. Pediatrics. 2006 Jun;117(6): 2074–9. doi: 10.1542/peds.2005-2307
Knight SJ, Politis J, Garnham C, Scheinberg A, Tollit MA. School Functioning in Adolescents With Chronic Fatigue Syndrome. Front Pediatr. 2018;6:302. doi: 10.3389/ fped.2018.00302
Devendorf AR, Jackson CT, Sunnquist M, A Jason L. Defining and measuring recovery from myalgic encephalomyelitis and chronic fatigue syndrome: the physician perspective. Disabil Rehabil. 2019;41(2):158-165. doi: 10.1080/09638288.2017.1383518
Sunnquist M, Nicholson L, Jason LA, Friedman KJ. Access to Medical Care for Individuals with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: A Call for Centers of Excellence. Mod Clin Med Res. 2017 Apr;1(1):28–35. doi: 10.22606/mcmr. 2017.11005
Bhui KS, Dinos S, Ashby D, Nazroo J, Wessely S, White PD. Chronic fatigue syndrome in an ethnically diverse population: the influence of psychosocial adversity and physical inactivity. BMC Med. 2011 Mar 21;9:26. doi: 10.1186/1741-7015-9-26
Viner R, Hotopf M. Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort study. BMJ. 2004 Oct 23; 329(7472):941. doi: 10.1136/bmj. 38258.507928.55
Hilland GH, Anthun KS. Socioeconomic determinants of myalgic encephalomyelitis/chronic fatigue syndrome in Norway: a registry study. BMC Public Health. 2024 May 13;24(1):1296. doi: 10.1186/s12889-024-19908-6
Castro-Marrero J, Faro M, Zaragozá MC, Aliste L, de Sevilla TF, Alegre J. Unemployment and work disability in individuals with chronic fatigue syndrome/myalgic encephalomyelitis: a community-based cross-sectional study from Spain. BMC Public Health. 2019 Jun 28;19(1):840. doi: 10.1186/ s12889-019-7225-z
