Unidentified chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: Surveillance outcomes from school-based clinics

Esther M. Crawley*, Alan M. Emond, Jonathan A C Sterne

*Corresponding author for this work

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


Objective: To investigate the feasibility of conducting clinics for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in schools. Design: School-based clinical project. Participants: Children aged 11-16 years were enrolled in three state secondary schools in England. Main outcome measures: Number of children newly diagnosed as having CFS/ME. Methods: Attendance officers identified children missing ≥20% of school in a 6-week term without a known cause, excluding those with a single episode off school, a known medical illness explaining the absence or known to be truanting. Children with fatigue were referred to a specialist CFS/ME service for further assessment. The authors compared children with CFS/ME identified through school-based clinics with those referred via health services. Outcomes of CFS/ME were evaluated at 6 weeks and 6 months. Results: 461 of the 2855 enrolled children had missed ≥20% school over a 6-week period. In 315, of whom three had CFS/ME, the reason for absence was known. 112 of the 146 children with unexplained absence attended clinical review at school; two had been previously diagnosed as having CFS/ME and 42 were referred on to a specialist clinic, where 23 were newly diagnosed as having CFS/ME. Therefore, 28 of the 2855 (1.0%) children had CFS/ME. Children with CFS/ME identified through surveillance had been ill for an amount of time comparable to those referred via health services but had less fatigue (mean difference 4.4, 95% CI 2.2 to 6.6), less disability (mean difference -5.7, 95% CI -7.9 to -3.5) and fewer symptoms (mean difference 1.86, 95% CI 0.8 to 2.93). Of 19 children followed up, six had fully recovered at 6 weeks and a further six at 6 months. Conclusions: Chronic fatigue is an important cause of unexplained absence from school. Children diagnosed through school-based clinics are less severely affected than those referred to specialist services and appear to make rapid progress when they access treatment.

Translated title of the contributionUnidentified Chronic Fatigue Syndrome (CFS/ME) is a major cause of school absence: surveillance outcomes from school based clinics
Original languageEnglish
Article numbere000252
JournalBMJ Open
Issue number2
Publication statusPublished - Dec 2011


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