Mental health articles

Chronic fatigue syndrome

This is a condition in which severe disabling fatigue persists for over six months (three months in children) and is associated with a variety of other associated symptoms unexplained by primary physical or psychiatric causes.

The most significant complaint on presentation is one of fatigue often preceded by a flu-like illness from which complete recovery has not been made. Associated low mood, mental fatigue and inability to concentrate are not uncommon. Girls are more affected than boys. The aetiological model is complex and physical and psychological factors have been suggested. The presence of persistent viral infection, muscular dysfunction, immune dysfunction and electrolyte imbalance have all been implicated. Low mood, anxiety and depression are not uncommon and, in up to a third of cases, depression may be present. While most cases remain ambulant, in very severe forms, children may be confined to a wheelchair and remain disabled from taking part in normal activity over a period of years. These children often present in paediatric clinics and may be resistant to transfer to child and adolescent mental health services as they see the principle cause of the problems as organic. It is best to adopt a supportive role while remaining open to discussion about the relative contribution of physical and psychological factors involved.

Individual work with the child in using behavioural and cognitive strategies in goal-setting and encouraging graded rehabilitation has been found to be beneficial. It is important to involve the family in examining attitudes to illness and in encouraging compliance with treatment plans.

Tags: chronic, chronic fatigue syndrome, fatigue, symptoms