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Eur Child Adolesc Psychiatry (2009) 18:683689 DOI 10.1007/s00787-009-0029-4
ORIGINAL CONTRIBUTION
Anxiety in children with CFS/ME
Esther Crawley Linda Hunt Paul Stallard
Received: 5 October 2008 / Accepted: 1 May 2009 / Published online: 19 May 2009 Springer-Verlag 2009
Abstract Anxiety symptoms are commonly described in children with chronic fatigue syndrome or myalgic encephalopathy (CFS/ME) but to date there has been little information on the type of anxiety children experience or the relationship between anxiety and school attendance, disability or fatigue. The aim of this study was to rst describe the prevalence and type of anxiety symptoms in children with CFS/ME compared with a normal European population, and secondly to investigate the association of anxiety symptoms with age, gender, school attendance, fatigue, and physical function in paediatric CFS/ME. Data were prospectively collected on children and young people with CFS/ME referred to a large specialist CFS/ME service. One hundred and sixty-four children with CFS/ME had complete data for the Spence Childrens Anxiety Scale. Teenage girls had the highest rates of total anxiety symptoms with 38% (95% CI 2749) over the cut off (top 10% of normal European population) and signicantly higher rates of symptoms in each subscale. Younger girls were more likely to score over the cut off in separation anxiety
(37%, 1940) and social phobia (39%, 2547). There was no evidence of association between total anxiety symptoms and: time at school, time to assessment, pain or age. Associations with fatigue and physical function were attenuated when adjusted for other variables. Although anxiety symptoms are high in CFS/ME, particularly in teenage girls, it does not appear to be associated with school attendance or other measures of disability. Separation anxiety and social phobia were the most clearly elevated in paediatric CFS/ME.
Keywords Anxiety Paediatric
Chronic fatigue syndrome ME
Introduction
Chronic fatigue syndrome or myalgic encephalopathy (CFS/ME) affects between 0.1 and 2% of children aged under 18 [3, 9, 12, 13, 17, 20] and is the most common cause of school absence in the UK [5]. CFS/ME is dened in the Royal College of Paediatrics and Child Health (RCPCH) as generalised fatigue persisting after routine tests, and investigations have failed to identify an obvious underlying cause [21]. The National Institute for Health and Clinical Excellence (NICE) recommended in 2007...