AHMF: 98 Conference: Neary

Psychological Factors in Adolescents with Chronic Fatigue

Sally Neary, Florence Levy, Dianne Fitzjames, John B. Ziegler

Departments of Immunology and Child & Adolescent Psychiatry
Sydney Children's Hospital
Randwick NSW 2031
E-mail: J.Ziegler@unsw.edu.au

Chronic fatigue syndrome (CFS) continues to provoke controversy in medical and psychiatric circles, as well as in the popular press. Its aetiology remains unknown, though theories abound, and no definitive treatment is currently available.

In the present study the emphasis was on investigating psychological factors in CF in adolescents. A group of adolescents with CFS or idiopathic chronic fatigue (n=30) was compared with: a psychiatric control group (adolescents being treated for anxiety, depression or psychosocial problems: n=17); two control groups of adolescents with chronic diseases (rheumatological conditions (n=22) and diabetes (n=24); and a healthy control group (adolescents attending accident and emergency for minor acute problems: n=24).

The subjects, drawn from hospital inpatient and outpatient populations, were compared on a set of self-report psychological measures. Level of fatigue, depression, and anxiety were measured and group differences were investigated.

It was found that the CF group was significantly more fatigued than the control groups. Anxiety and depression were also observed to be significantly higher in the CF subjects and psychiatric group than the other controls.

There were no significant differences in anxiety and depression between adolescents with CF and those in the psychiatric control group. These results support findings in the adult literature, are consistent with (but do not establish) a role for psychological factors in the development of symptoms and thus provide some much lacking information about the psychological aspects of CF in adolescents.

Although conclusions as to the causal status of psychological factors in CFS cannot be drawn from this study, it does support a cognitive-behavioural approach to the management of CFS in adolescents.