What treatments work for anxiety and depression in children and adolescents with Chronic Fatigue Syndrome? An updated systematic review

Philippa Clery*, Alexander Royston , Katie Driver, Jasmine Bailey, Esther M Crawley, Maria Loades

*Corresponding author for this work

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

2 Citations (Scopus)

Abstract

Objectives: 
Children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) experience a higher prevalence of depression and anxiety compared with age-matched controls. Our previous systematic reviews in 2015/16 found little evidence for effective treatment for children with CFS/ME with comorbid depression and/or anxiety. This review updates these findings.

Design: 
A systematic review. We searched Cochrane library, Medline, Embase and PsycINFO databases from 2015 to 2020. We combined the updated results with our previous reviews in a narrative synthesis.

Participants: 
Inclusion criteria: <18 years old; diagnosed with CFS/ME (using Centers for Disease Control and Prevention, National Institute for Health and Care Excellence or Oxford criteria); validated measures of depression and/or anxiety.

Interventions: 
Observational studies or randomised controlled trials.

Comparison: 
Any or none.

Outcomes: 
Studies with outcome measures of anxiety, depression or fatigue.

Results: 
The updated review identified two studies. This brings the total number of paediatric CFS/ME studies with a measure of anxiety and/or depression since 1991 to 16. None of the studies specifically targeted depression, nor anxiety. One new study showed the Lightning Process (in addition to specialist care) was more effective at reducing depressive and anxiety symptoms compared with specialist care alone. Previous studies evaluated cognitive–behavioural therapy (CBT); pharmacological interventions and behavioural approaches. CBT-type interventions had most evidence for improving comorbid anxiety and/or depressive symptoms but varied in delivery and modality. Other interventions showed promise but studies were small and have not been replicated.

Conclusion: 
Very few paediatric CFS/ME intervention studies have been conducted. This review update does not significantly add to what is known from previous reviews. The evidence is of poor quality and insufficient to conclude which interventions are effective at treating comorbid anxiety and/or depression in paediatric CFS/ME.

PROSPERO registration numbers: 
CRD42016043488 and CRD42015016813.
Original languageEnglish
Article numbere051358
Number of pages14
JournalBMJ Open
Volume12
Issue number1
Early online date31 Jan 2022
DOIs
Publication statusPublished - 31 Jan 2022

Bibliographical note

Funding Information:
ML is funded by the National Institute for Health Research (NIHR Doctoral Research Fellowship, DRF-2016-09-021). This report is independent research.

Publisher Copyright:
© Author(s) (or their employer(s)) 2022.

Keywords

  • Paediatric, CFS/ME
  • chronic fatigue syndrome
  • anxiety
  • depression

Fingerprint

Dive into the research topics of 'What treatments work for anxiety and depression in children and adolescents with Chronic Fatigue Syndrome? An updated systematic review'. Together they form a unique fingerprint.

Cite this