Psychiatric adjustment in chronic fatigue syndrome of childhood and in juvenile idiopathic arthritis

Psychol Med. 2003 Feb;33(2):289-97. doi: 10.1017/s0033291702006529.


Background: High rates of psychopathology and of personality problems have been reported in children and adolescents with chronic fatigue syndrome (CFS). It is not clear whether this is consequent on the experience of chronic physical ill health. We compare psychiatric adjustment in children with CFS and in children suffering from another chronic physical disorder (juvenile idiopathic arthritis or JIA).

Method: Our sample consisted of 28 children with CFS and 30 with JIA attending tertiary paediatric centres (age range, 11 to 18 years, mean 15, S.D. 2.3). In order to assess psychiatric status and functioning, we used the K-SADS psychiatric interviews, CGAS and Harter Self-Esteem Questionnaire with child subjects; behavioural questionnaires (CBCL) and child personality assessment interviews (PAS) with parent informants.

Results: Psychiatric disorders in the year prior to interview had been present significantly more commonly in the CFS group (72% v. 34% in JIA) and were more impairing to them (CGAS scores of 45 v. 77). Most common diagnoses in both groups were depressive and anxiety disorders. Personality problems were also significantly more frequent in CFS subjects (48% disorder and 26% difficulty v. 11% and 11% in JIA). There were few differences between the two groups in self-esteem.

Conclusions: Psychopathology and personality problems are common in children and adolescents with severe forms of CFS and cannot be explained strictly through the experience of chronic physical illness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / psychology*
  • Catchment Area, Health
  • Child
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • England / epidemiology
  • Fatigue Syndrome, Chronic / etiology*
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology
  • Personality Disorders / psychology
  • Prevalence
  • Severity of Illness Index
  • Socioeconomic Factors