From Archives of Diseases in Childhood, 30 May 2012
Co-morbid conditions in children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) – a retrospective case note review of a large cohort
LM Oliver(1), K Patel(2)
(1) Brighton and Sussex Medical School, Brighton and Sussex University Hospitals (BSUH), Brighton, UK
(2) Royal Alexandra Children's Hospital, Brighton and Sussex University Hospitals (BSUH), Brighton, UK
Abstract
AIMS: CFS/ME is a complex illness, causing severe incapacitating fatigue, physical and cognitive complaints and is as disabling as many other serious chronic conditions. The prevalence in children is estimated to be 0.2-0.5%. The aim of this study was to take a cohort of children and adolescents with the condition and determine the pattern of co-morbid conditions.
METHODS: Our study took the form of a quantitative and semi-qualitative analysis undertaken as a retrospective case note review of a cohort of 131 patients attending a hospital based, consultant-led specialist CFS/ME clinic. Patients must have been diagnosed with CFS/ME using NICE and RCPCH criteria whilst under the care of a consultant paediatrician to be eligible to be included in the study. Information gathered from their hospital notes included basic demographics, CFS/ME diagnosis information and any co-morbid conditions present.
RESULTS; 80% of patients were female which was as expected, with CFS/ME acknowledged to be a female dominated disease. The median age at diagnosis of CFS/ME was 14 years, and there were a total of 38 different symptoms recorded at diagnosis. Other than fatigue, the most common symptoms were headaches, abdominal pain, musculoskeletal pain and decreased concentration and short term memory.
56% of the cohort had at least 1 co-morbid condition. There were 51 separate co-morbid conditions, with the most common conditions being psychiatric, gastrointestinal, respiratory and musculoskeletal problems. 30% of the patients had at least 1 co-morbid condition that the RCPCH lists as a differential diagnosis of CFS/ME.
CONCLUSION: This is the first study exploring co-morbid conditions in children and adolescents with CFS/ME. More than half of the cohort had at least one co-morbid condition. We wish to highlight to paediatricians that the presence of a co-morbid differential diagnosis does not appear to exclude CFS/ME.
A stunningly brilliant conclusion – having an illness doesn’t mean you can’t also have M.E!
If I understand the report, 56% had more than one illness; really? Over half had M.E. AND something else? The most common ‘other’ condition was psychiatric (surprise, surprise) – a subjective diagnosis; it wasn’t ‘merely’ psychological problems which were most prevalent – no, no, they were psychiatric . Is anybody going to believe that. Is anybody going to give the ‘study’ any credence?
And note the method included, a “..semi-qualitative analysis undertaken as a retrospective case note review…” – whatever ‘semi-qualitative analysis” is (does it mean ‘no evidence, so we guessed’?) – and they didn’t speak to any patients, they just read some notes and speculated.
Does anyone remember McEvedy and Beard?
Now you have reminded me of the ancient villians…oh yes!
Having ME/CFS makes you depressed. Like we needed a research project to tell us that!