The presence of co-morbid mental health problems in a cohort of adolescents with chronic fatigue syndrome

• Published in: Clinical child psychology and psychiatry Vol. 23; no. 3; pp. 398 - 408
• Main Authors: Loades, Maria Elizabeth, Rimes, Katharine A, Ali, Sheila, Lievesley, Kate, Chalder, Trudie
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-07-2018; SAGE PUBLICATIONS, INC
• Subjects: Adjustment; Adolescent; Adolescents; Anxiety; Anxiety Disorders - epidemiology; Child; Child & adolescent psychiatry; Children with disabilities; Chronic fatigue syndrome; Chronic mental disorders; Clinical assessment; Cohort Studies; Comorbidity; Cross-Sectional Studies; Depressive Disorder, Major - epidemiology; Depressive personality disorders; Fatigue; Fatigue Syndrome, Chronic - epidemiology; Female; Health problems; Humans; Male; Medical diagnosis; Medical screening; Mental depression; Mental disorders; Mental health; Questionnaires; Self report; Social anxiety; Teenagers; Trait anxiety; anxiety; CFS/ME; depression; adolescents; MINI-KID; Chronic fatigue syndrome
• ISSN: 1359-1045; 1461-7021
• DOI: 10.1177/1359104517736357

Objective:
To report on the prevalence of mental health disorders in adolescents with chronic fatigue syndrome (CFS) and to compare the diagnoses identified by a brief clinician-administered psychiatric interview with self-report screening questionnaires.
Design:
Cross-sectional study.
Setting:
Consecutive attenders to specialist CFS clinics in the United Kingdom.
Patients:
N = 52 adolescents, age 12–18 years with CFS.
Measures:
Self-report questionnaires and a brief structured psychiatric diagnostic interview, administered by a researcher.
Results:
On the psychiatric interview, 34.6% met a diagnosis of major depressive disorder and 28.8% had an anxiety disorder. Of these, 15% had co-morbid anxiety and depression. Those with a depression diagnosis reported significantly greater interference on the school and social adjustment scale. They also scored significantly higher on trait anxiety, but not on state anxiety. There were no differences between those who had an anxiety disorder and those who did not on fatigue, disability or depressive symptoms. Children’s Depression Inventory (CDI) score was associated with a depression diagnosis on the psychiatric interview. However, neither the state nor the trait subscale of the State-Trait Anxiety Inventory (STAI) was associated with an anxiety diagnosis.
Conclusion:
Clinicians should assess for the presence of anxiety and depressive disorders in adolescents with CFS using a validated psychiatric interview. Treatment should be flexible enough to accommodate fatigue, depression and anxiety. Transdiagnostic approaches may suit this purpose. Goals should include pleasurable activities particularly for those who are depressed.