title: How fatigue is related to other somatic symptoms.
abstract: OBJECTIVE
  To assess the relation between fatigue and somatic symptoms in healthy adolescents and adolescents with chronic fatigue syndrome/myalgic encephalopathy (CFS/ME).
  
  
  METHODS
  Seventy two adolescents with CFS were compared within a cross-sectional study design with 167 healthy controls. Fatigue and somatic complaints were measured using self-report questionnaires, respectively the subscale subjective fatigue of the Checklist Individual Strength (CIS-20) and the Children's Somatization Inventory.
  
  
  RESULTS
  Healthy adolescents reported the same somatic symptoms as adolescents with CFS/ME, but with a lower score of severity. The top 10 somatic complaints were the same: low energy, headache, heaviness in arms/legs, dizziness, sore muscles, hot/cold spells, weakness in body parts, pain in joints, nausea/upset stomach, back pain. There was a clear positive relation between log somatic symptoms and fatigue (linear regression coefficient: 0.041 points log somatic complaints per score point fatigue, 95% CI 0.033 to 0.049) which did not depend on disease status.
  
  
  CONCLUSIONS
  Results suggest a continuum with a gradual transition from fatigue with associated symptoms in healthy adolescents to the symptom complex of CFS/ME.
authors.affiliation: Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. E.vandePutte@umcutrecht.nl
authors.forename: E M
authors.initials: EM
authors.lastname: van de Putte
authors.forename: R H H
authors.initials: RH
authors.lastname: Engelbert
authors.forename: W
authors.initials: W
authors.lastname: Kuis
authors.forename: J L L
authors.initials: JL
authors.lastname: Kimpen
authors.forename: C S P M
authors.initials: CS
authors.lastname: Uiterwaal
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis*