Natural course of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis in adolescents

Tom Norris, Simon Collin, Kate Tilling, Roberto Nuevo, Stephen Stansfeld, Jonathan Sterne, Jon Heron, Esther Crawley

Research output: Contribution to journalArticle (Academic Journal)peer-review

16 Citations (Scopus)
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OBJECTIVE: Little is known about persistence of or recovery from chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adolescents. Previous studies have small sample sizes, short follow-up or have focused on fatigue rather than CFS/ME or, equivalently, chronic fatigue, which is disabling. This work aimed to describe the epidemiology and natural course of CFS/ME in adolescents aged 13-18 years.DESIGN: Longitudinal follow-up of adolescents enrolled in the Avon Longitudinal Study of Parents and Children.SETTING: Avon, UK.PARTICIPANTS: We identified adolescents who had disabling fatigue of >6 months duration without a known cause at ages 13, 16 and 18 years. We use the term 'chronic disabling fatigue' (CDF) because CFS/ME was not verified by clinical diagnosis. We used multiple imputation to obtain unbiased estimates of prevalence and persistence.RESULTS: The estimated prevalence of CDF was 1.47% (95% CI 1.05% to 1.89%) at age 13, 2.22% (1.67% to 2.78%) at age 16 and 2.99% (2.24% to 3.75%) at age 18. Among adolescents with CDF of 6 months duration at 13 years 75.3% (64.0% to 86.6%) were not classified as such at age 16. Similar change was observed between 16 and 18 years (75.0% (62.8% to 87.2%)). Of those with CDF at age 13, 8.02% (0.61% to 15.4%) presented with CDF throughout the duration of adolescence.CONCLUSIONS: The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years.
Original languageEnglish
Pages (from-to)522-528
Number of pages7
JournalArchives of Disease in Childhood
Issue number6
Early online date19 Jan 2017
Publication statusPublished - Jun 2017


  • Chronic fatigue syndrome
  • CFS/ME
  • adolescent
  • longitudinal


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