Clinicians have been describing individuals with chronic fatigue states for over 100 years, although chronic fatigue syndrome is often regarded as a modern disease. The aetiology of chronic fatigue syndrome is uncertain. For young individuals with chronic fatigue syndrome there are neither reliable prevalence figures nor scientific evidence concerning the effectiveness of treatments. Information obtained from research into adult individuals with chronic fatigue syndrome may be helpful but is not necessarily directly applicable to children and adolescents. Developmental factors and the influence of other family members on the course of the disorder in young sufferers should be considered. The uncertainties surrounding chronic fatigue syndrome should not deter child and adolescent mental health workers from becoming involved in the assessment and management of individual patients. The mainstay of treatment is rehabilitation with an emphasis on gradually increasing activities. Considerable attention will need to be given to engaging the young people and their families and working effectively with a multidisciplinary team. If mental health workers do not become involved in treating young people with chronic fatigue syndrome there is a risk that psychological factors will not be addressed and that chronic functional impairment will ensue.
Abbey, S.E.
, & Garfinkle, P.E. (1991). Neurasthenia and chronic fatigue syndrome: The role of culture in the making of a diagnosis. American Journal of Psychiatry, 148, 1638-1646.
2.
American Psychiatric Association
. (1987). Diagnostic and statistical manual of mental disorders (3rd ed, rev.). Washington, DC: American Psychiatric Press.
3.
Association for Child Psychology and Psychiatry
(1999). Chronic fatigue syndrome: Helping children and adolescents. Occasional Paper No. 16 (E. Garralda, Ed.). London: The Association for Child Psychology and Psychiatry.
4.
Ayers, J.G.
, et al. (1998). Post-infection fatigue syndrome following Q fever. Quarterly Journal of Medicine, 91, 105-123.
5.
Bates, D.W.
, Schmitt, W., Buchwald, D., Ware, N.C., Lee, J., Thoyer, E., Kornish, J., & Komaroff, A.L. (1993). Prevalence of fatigue and chronic fatigue syndrome in a primary care practice. Archives of Internal Medicine, 153, 2759-2765.
6.
Bates, P.
, Kurtz, Z., Cumella, S., Richardson, G., Farrar, M., Shooter, M., Kerfoot, M., White, R., Williams, R., Berger, M., Hill, P., Sang, B., & Walk, D. (1995). Child and Adolescent Mental Health Services. Together We Stand. In R. Williams & G. Richardson (Eds.), The commissioning, role and management of child and mental health services. London: HMSO.
7.
Beard, G.M.
(1869). Neurasthenia or nervous exhaustion. Boston Medical and Surgical Journal, 3 (new series), 217-221.
8.
Behan, P.O.
, Behan, W.M.H., & Horrobin, D. (1990). Effect of high doses of essential fatty acids on the post viral fatigue syndrome. Acta Neurologica Scandinavica, 82, 209-216.
9.
Berg, I.
(1992). Absence from school and mental health. British Journal of Psychiatry, 161, 154-166.
10.
Berg, I.
(1997). School refusal and truancy. Archives of Disease in Childhood, 76, 90-91.
11.
Berg, I.
, Butler, A., Franklin, J., Hayes, H., Lucas, C., & Sims, R. (1993). DSM-III-R disorders, social factors and management of school attendance problems in the normal population. Journal of Child Psychology, Psychiatry and Allied Disciplines, 34, 1187-1203.
12.
Bernstein, G.A.
, Massie, E.D., Thuras, P.D., Perewien, A.R., Borchardt, C.M., & Crosby, R.D. (1997). Somatic symptoms in anxious-depressed school refusers. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 661-668.
13.
Blair, C.
, Freeman, C., & Cull, A. (1995). The families of anorexia nervosa and cystic fibrosis patients. Psychological Medicine, 25, 985-993.
14.
Brent, D.A.
, Holder, D., Kolko, D., Birmaher, B., Baugher, M., Roth, C., Iyengar, S., & Johnson, B.A. (1997). A clinical psychotherapy trial for adolescent depression comparing cognitive, family and supportive therapy. Archives of General Psychiatry, 54, 877-885.
15.
Breuer, J.
, & Freud, S. (1893–1895/1991). Studies on hysteria (A.Richards, Ed.). London: Penguin Books.
16.
Cantwell, D.P.
, & Rutter, M. (1994). Classification: Conceptual issues and substantive findings. In M. Rutter, E. Taylor, & L. Hersov (Eds.), Child and adolescent psychiatry modern approaches (pp. 946-967). Oxford, UK: Blackwell Scientific Publications.
17.
Carter, B.D.
, Edwards, J.F., Kroenenberger, W.G., Michalczyk, L., & Marshall, G.S. (1995). Case control study of chronic fatigue in pediatric patients. Pediatrics, 95, 179-186.
18.
Carter, B.D.
, Kroenenberger, W.G., Edwards, J.F., Michalczyk, L., & Marshall, G.S. (1996). Differential diagnosis of chronic fatigue in children: Behavioral and emotional dimensions. Developmental and Behavioral Pediatrics, 17, 16-21.
19.
Chalder, T. (1990). A scale for measuring chronic fatigue syndrome. Unpublished Thesis, City University, London.
20.
Cleare, A.J.
, & Wessely, S.C. (1996). Chronic fatigue syndrome: A stress disorder?British Journal of Hospital Medicine, 55, 571-574.
21.
Compston, N.D.
(1978). An outbreak of encephalomyelitis in the Royal Free Hospital Group, London in 1955. Postgraduate Medical Journal, 54, 722-724.
22.
Cope, H.
, Pernet, A., Kendall, B., & David, A. (1995). Cognitive functioning and magnetic resonance imaging in chronic fatigue. British Journal of Psychiatry, 167, 86-94.
23.
Cox, D.
, & Findley, L. (1994). Chronic fatigue syndrome in adolescence. British Journal of Hospital Medicine, 51, 614.
24.
Cox, I.M.
, Campbell, M.J., & Dowson, D. (1991). Red blood cell magnesium and chronic fatigue syndrome. The Lancet, 337, 757-760.
25.
David, A.
, Wessely, S., & Pelosi, A. (1988). Postviral fatigue syndrome: Time for a new approach. British Medical Journal, 296, 696-699.
26.
David, A.
, Wessely, S., & Pelosi, A. (1991). Chronic fatigue syndrome: Signs of a new approach. British Journal of Hospital Medicine, 45, 158-163.
27.
Dawson, J.
(1987). Royal Free Disease: perplexity continues. British Medical Journal, 294, 327-328.
28.
Deale, A.
, Chalder, T., Marks, I., & Wessely, S. (1997). Cognitive Behaviour Therapy for Chronic Fatigue Syndrome: a randomised controlled trial. American Journal of Psychiatry, 154, 408-414.
29.
Deale, A.
, Chalder, T., & Wessely, S. (1998). Illness beliefs and treatment outcome in chronic fatigue syndrome. Journal of Psychcosomatic research, 45, 77-83.
30.
Dowsett, E.G.
, & Colby, J. (1997). Long-term sickness absence due to ME/CFS in UK schools: An Epidemiological Study with Medical and Educational Implications. Journal of Chronic Fatigue Syndrome, 3, 29-42.
31.
Emslie, G.J.et al.
(1997). A Double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Archives of General Psychiatry, 54, 1031-1037.
32.
Euba, R.
, Chalder, T., Deale, A., & Wessely, S. (1996). Comparison of the characteristics of chronic fatigue syndrome in primary and tertiary care. British Journal of Psychiatry, 168, 121-126.
33.
Feder, H.M.
, Dworkin, P.H., & Orkin, C. (1994). Outcome of 48 Pediatric Patients With Chronic Fatigue. Archives of Family Medicine, 3, 1049-1055.
34.
Fischler, B.
, Cluydts, R., De Gucht, V., Kaufman, L., & De Meirlier, K. (1997). Generalised anxiety disorder in Chronic Fatigue Syndrome. Acta Psychiatrica Scandinavica, 95, 405-413.
35.
Franklin, A.
(1995). Children with ME.Guidelines for School Doctors and General Practitioners. Stanford le Hope: ME Association.
36.
Franklin, A.
(1997). Including patients who rated themselves as a little better would have altered results. British Medical Journal, 315, 947.
37.
Fry, A.M.
, & Martin, M. (1996). Cognitive idiosyncracies among children with the chronic fatigue syndrome; anomalies in self-reported activity levels. Journal of Psychosomatic Research, 41, 213-223.
38.
Fukuda, K.
, Straus, S.E., Hickie, I., Sharpe, M.C., Dobbins, J.G., & Komaroff, A. (1994). The Chronic Fatigue Syndrome: a comprehensive aproach to its definition and study. Annals of Internal Medicine, 121, 953-959.
39.
Fulcher, K.Y.
, & White, P.D. (1997). Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. British Medical Journal, 314, 1647-1652.
40.
Garralda, E.M.
(1992) Severe Chronic Fatigue Syndrome in childhood – a discussion of psychopathological mechanisms. European Journal of Child and Adolescent Psychiatry, 1, 111-118.
41.
Garralda, E.M.
(1996). Somatisation in children. Journal of Child Psychology and Psychiatry, 37, 13-33.
42.
Godlee, F.
(1997). Plague or pure hype. British Medical Journal, 314, 1700.
43.
Graham, H.
(1990). Family interventions in general practice: A case of chronic fatigue. Journal of Family Therapy, 13, 225-230.
44.
Griffiths, R.A.
, Beumont, P.J., Moore, G.M., & Touyz, S.W. (1996). Chronic fatigue syndrome and dieting disorders: Diagnosis and management problems. Australian and New Zealand Journal of Psychiatry, 30, 834-838.
45.
Joyce, J.
, Hotopf, M., & Wessely, S. (1997). The prognosis of chronic fatigue and chronic fatigue syndrome: A systematic review. Quartely Journal of Medicine, 90, 223-233.
46.
Kennedy, J.
, & Pearce, J.B. (1995). Chronic fatigue syndrome in childhood. Current Opinion in Psychiatry, 8, 231-234.
47.
Khawaja, S.S.
, & Van Boxel, P. (1998). Chronic fatigue syndrome in childhood: Seven year follow-up study. Psychiatric Bulletin, 22, 198-202.
48.
Lane, T.J.
, Manu, P., & Mathews, D.A. (1991). Depression and somatization in the chronic fatigue syndrome. American Journal of Medicine, 91, 335-344.
49.
Lask, B.
, & Dillon, M. (1990). Postviral fatigue syndrome. Archives of Disease in Childhood, 65, 1198.
50.
Lask, B.
, & Fosson, A. (1989). Childhood illness: The psychosomatic approach. Chichester, UK: Wiley.
51.
Lawrie, S.M.
, MacHale, S.M., Power, M.J., & Goodwin, G.M. (1997). Is the chronic fatigue syndrome best understood as a primary disturbance of the sense of effort?Psychological Medicine, 27, 995-999.
52.
Lemert, E.
(1972). Human deviance, social problems and social control. Englewood Cliffs, NJ: Prentice Hall.
53.
Lipowski, Z.
(1967). Review of consultation psychiatry and psychosomatic medicine: II. Clinical aspects. Psychosomatic Medicine, 29, 201-224.
54.
Marcovitch, H.
(1997). Managing chronic fatigue syndrome in children. British Medical Journal, 314, 1635-1636.
55.
McCauley, E.
, Carlson, G.A., & Calderon, R. (1991). The role of somatic complaints in the diagnosis of depression in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 631-635.
56.
Mechanic, D.
(1962). The concept of illness behaviour. Journal of Chronic Disease, 15, 189-194.
57.
Merskey, H.
(1995). The analysis of hysteria. Understanding conversion and dissociation. London: Gaskell.
58.
Minuchin, S.
, Baker, L., Rosman, B.L., Liebman, R., Milman, L., & Todd, T.C. (1975). A conceptual model of psychosomatic illness in children. Archives of General Psychiatry, 32, 1031-1038.
59.
Pelcovitz, D.
, Septimus, A., Friedman, S.B., Krilov, L.R., Mandel, F., & Kaplan, S. (1995). Psychosocial correlates of chronic fatigue syndrome in adolescent girls. Developmental and Behavioral Paediatrics, 16, 333-338.
60.
Piloplys, A.V.
(1997). Chronic fatigue syndrome should not be diagnosed in children. Pediatrics, 100, 270-271.
61.
Pilowsky, I.
(1969). Abnormal illness behaviour. British Journal of Medical Psychology, 42, 347-351.
62.
Pipe, R.
, & Waite, M. (1995). Family therapy in the treatment of chronic fatigue syndrome in adolescence. Association for Child Psychology and Psychiatry Review Newsletter, 17, 9-16.
63.
Richards, J.A.
, & Smith, F. (1998). Chronic fatigue syndrome in children and adolescents: General practitioners experience of the problem and their views about its treatment. Psychiatric Bulletin, 22, 203-206.
64.
Rowe, K.S.
(1997). Double-blind randomised controlled trial to assess the efficacy of intravenous gammaglobulin for the management of chronic fatigue syndrome in adolescents. Journal of Psychiatric Research, 31, 133-147.
65.
Royal Colleges of Physicians, Psychiatrists, & General Practitioners. (1996). Chronic fatigue syndrome. Report of a joint working group. London: The Royal Colleges of Physicians, Psychiatrists and General Practitioners.
66.
Salit, I.E.
(1997). The chronic fatigue syndrome: An update on important issues. In Y. Shlomo & D.I. Motofsty (Eds.), Chronic Fatigue Syndrome (pp. 51-72). London: Plenum.
67.
Scott, S.
, Deary, I., & Pelosi, A.J. (1995). General practitioners’ attitudes to patients with a self diagnosis of myalgic encephalomyelitis. British Medical Journal, 310, 508.
68.
Sharpe, M.
(1996). Chronic fatigue syndrome. The Psychiatric Clinics of North America, 19, 549-573.
69.
Sharpe, M.
, Archard, L.C., Banatvala, J.E., Borysiewicz, L.K., Clare, A.W., David, A., Edwards, R.H.T., Hawton, K.E.H., Lambert, H.P., Lane, R.J.M., Mc Donald, E.M., Mowbray, J.F., Pearson, D.J., Peto, T.E.A., Preedy, V.R., Smith, A.P., Smith, D.G., Taylor, D.J., Tyrrel, D.A.J., Wessely, S., & White, P.D. (1991). A report – Chronic fatigue syndrome: Guidelines for research. Journal of the Royal Society of Medicine, 84, 118-121.
70.
Sharpe, M.
, Hawton, K., Simkin, S., Surawy, C., Hackmann, A., Klimes, I., Peto, T., Warrel, D., & Seagrott, V. (1996). Cognitive behaviour therapy for the chronic fatigue syndrome: A randomised controlled trial. British Medical Journal, 312, 22-26.
71.
Sharpe, M.
, Hawton, K., Clements, A., & Cowen, P.J. (1997). Increased brain serotonin function in men with chronic fatigue syndrome. British Medical Journal, 315, 164-165.
72.
Sharpe, M.
, Hawton, K., Seagrott, V., & Pasvol, G. (1992). Follow-up of patients presenting with fatigue to an infectious diseases clinic. British Medical Journal, 305, 147-152.
73.
Shepherd, C.
(1995). Myalgic encephalomyelitis: Post-viral fatigue syndrome. Guidelines for the care of patients (2nd ed.). Stanford le Hope, UK: M.E. Association.
74.
Shepherd, C.
, & Macintyre, A. (1997). Patients should have an initial period of rest before gradual increase in activity. British Medical Journal, 315, 947.
75.
Smith, M.S.
, Mitchell, J., Corey, L., Gold, D., McCauley, E.A., Glover, D., & Tenover, F.C. (1991). Chronic fatigue in adolescents. Pediatrics, 88, 195-202.
76.
Spence, S.H.
(1994). Cognitive therapy with children and adolescents: From theory to practice. Journal of Child Psychology and Psychiatry, 35, 1191-1228.
77.
Stark, K.D.
, Rouse, L.W., & Livingstone, R. (1991). Treatment of depression during childhood and adolescence: Cognitive behavioral procedures for the individual and the family. In P.C. Kendall, (Ed.), Child and adolescent therapy: Cognitive-behavioral proceedures (pp. 165-206). New York: Guilford Press.
78.
Vercoulen, J.H.
, Swanick, C.M., Zitman, F.G., Vreden, S.G., Vreden, S.G., Hoofs, M.P., Fennis, J.F., Galama, J.M., Van der Meer, J.W., & Bleijenberg, G. (1996). Randomised, controlled trial of fluoxetine in chronic fatigue syndrome. Lancet, 347, 858-861.
79.
Vereker, M.I.
(1992). Chronic fatigue syndrome: A joint paeditric–pychiatric approach. Archives of Disease in Childhood, 67, 550-555.
80.
Walford, G.A.
, McNelson, W., & McCluskey, D.R. (1993). Fatigue, depression, and social adjustment in chronic fatigue syndrome. Archives of Disease in Childhood, 68, 384-388.
81.
Wessely, S.
(1991). History of postviral fatigue syndrome. British Medical Bulletin, 47, 919-941.
82.
Wessely, S.
(1996). Chronic fatigue syndrome: An adult perspective. In K. Forrest (Ed.), Psychosomatic problems in children: Clinical research perspectives. Occasional Paper No. 12. London: Association of Child Psychology and Psychiatry.
83.
Wessely, S.
, Chalder, T., Hirsch, S., Wallace, P., & Wright, D. (1996). Psychological symptoms, somatic symptoms and psychiatric disorder in chronic fatigue and chronic fatigue syndrome: A prospective study in a primary care setting. American Journal of Psychiatry, 153, 1050-1059.
84.
Wessely, S.
, Chalder, T., Hirsch, S., Wallace, P., & Wright, D. (1997). The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: A prospective primary care study. American Journal of Public Health, 87, 1449-1455.
85.
Wessely, S.
, David, A., Butler, S., & Chalder, T. (1989). Management of chronic (post-viral fatigue syndrome. Journal of the Royal College of General Practitioners, 39, 26-29.
86.
Wessely, S.
, Hotopf, M., & Sharpe, M. (1998). Chronic fatigue and its syndromes. Oxford, UK: Oxford University Press.
87.
Wilson, A.
, Hickie, I., Lloyd, A., Hadzi-Pavlovic, D., Boughton, C., Dwyer, J., & Wakefield, D. (1994). Longitudinal study of outcome of chronic fatigue syndrome. British Medical Journal, 308, 756-759.
88.
Wing, J.K.
, & Brown, G.W. (1970). Institutionalisation and schizophrenia: A comparative study of three mental hospitals 1960–1968. Cambridge, UK: Cambridge University Press.
89.
Wood, A.
, Harrington, R., & Moore, A. (1996). Controlled trial of a brief cognitive- behavioral intervention in adolescent patients with depressive disorders. Journal of Child Psychology and Psychiatry, 37, 737-746.
90.
Medical Matters1.
91.
World Health Organisation
. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organisation.
