Adolescent health

Chronic fatigue syndrome in adolescents. Beyond tiredness



© ijubaphoto/ model used for illustrative purposes only
© ijubaphoto/ model used for illustrative purposes only


Chronic fatigue syndrome (CFS) in adolescents can have significant physical, social and psychological impacts. A comprehensive history and assessment and exclusion of other fatigue-causing conditions are crucial to timely diagnosis. An individualised multidisciplinary rehabilitative approach to adolescents with CFS is key to management.

Article Extract

Chronic fatigue syndrome (CFS) in adolescents is a condition primarily characterised by severe, persistent, unexplained fatigue.1 In CFS, the fatigue is exacerbated by exertion (postexertional malaise) and may be accompanied by other symptoms including musculoskeletal pain, cognitive ‘brain fog’, unrefreshing or disturbed sleep, and neurological and autonomic symptoms such as headache and dizziness on standing or exertion consistent with orthostatic intolerance.2 There are many proposed hypotheses for the aetiology of CFS including infectious agents, immune dysfunction, autoimmune disorders, genetic susceptibility or abnormality, neuroendocrine disorders, circulatory abnormalities, toxins, metabolic disturbances, or a combination of these.2,3 The estimated national incidence of paediatrician-diagnosed cases of CFS in adolescents aged 10 to 17 years in Australia is 6.38 per 100,000 per year.1 Adolescence has been identified as one of two age peaks in incidence of CFS in a Norwegian-based population registry study.4 Diagnostic criteria are based on commonly used case definitions for the diagnosis of CFS/myalgic encephalomyelitis (ME) in children and adolescents and are discussed in detail below.5-7