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JAMA Pediatrics Patient Page
April 2014

Chronic Fatigue Syndrome Among Adolescents

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Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2014;168(4):396. doi:10.1001/jamapediatrics.2013.3337

Chronic fatigue syndrome (CFS) is a complicated and controversial illness whose cause is not understood. The main symptom of chronic fatigue syndrome is long-lasting fatigue or tiredness (for at least 6 months) that makes it difficult for the patient to go about his or her daily activities. This fatigue does not improve with rest or sleep and may be worsened with physical or mental activity.

Other symptoms can include the following:

  • Weakness

  • Pain

  • Difficulty standing due to low blood pressure (often called orthostatic intolerance)

  • Difficulty thinking or remembering (often called cognitive impairment)

  • Difficulty sleeping or insomnia

Chronic fatigue syndrome is a real condition that unfortunately affects about 0.1% to 1% of adolescents. It is an important cause of disability among adolescents and may have negative effects on adolescents’ health and their social and academic lives.

Because there is no blood test or radiology scan that can diagnose CFS, it is a diagnosis that has traditionally only been made after ruling out other possible illnesses. It is not caused by any of the known viruses examined in multiple studies. A research study in this month’s JAMA Pediatrics tested adolescents with CFS. One finding of the study was that patients’ blood tests showed higher levels of sympathetic nerve activity. The sympathetic nervous system is active in conditions such as fear or illness. The researchers concluded that this result may show how the body responds to CFS, and these new research findings may help physicians develop tests for CFS.

Managing CFS is complex for several reasons. First, there is no cure for CFS. Second, symptoms can be a little different for every patient, and for any patient the symptoms can get better or worse over time. Patients and families should be careful in adopting therapies or medicines that companies or health care providers claim are able to cure CFS, because there is no known cure at this time. However, certain therapies such as cognitive behavioral therapy (also called CBT) and graded exercise therapy have been found to significantly reduce fatigue. Many patients with CFS also have depression, which can be successfully treated with therapy and medication. Researchers are seeking new medical treatments for CFS.

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The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Resource: Centers for Disease Control and Prevention