title: Incidence, prognosis, and risk factors for fatigue and chronic fatigue syndrome in adolescents: a prospective community study.
abstract: OBJECTIVE
  The objective of this study was to describe the incidence, prevalence, risk factors, and prognosis of fatigue, chronic fatigue, and chronic fatigue syndrome in 11- to 15-year-olds.
  
  
  METHODS
  A random general population sample (n = 842) of British adolescents and their parents were assessed at baseline and 4 to 6 months later. The main outcomes were fatigue, chronic fatigue, and chronic fatigue syndrome, operationally defined.
  
  
  RESULTS
  The incidence over 4 to 6 months was 30.3% for fatigue, 1.1% for chronic fatigue, and 0.5% for chronic fatigue syndrome. The point prevalence was 34.1% and 38.1% for fatigue, 0.4% and 1.1% for chronic fatigue, and 0.1% and 0.5% for chronic fatigue syndrome at time 1 and time 2, respectively. Of participants who were fatigued at time 1, 53% remained fatigued at time 2. The 3 cases of chronic fatigue and 1 case of chronic fatigue syndrome at time 1 had recovered by time 2. Higher risk for development of chronic fatigue at time 2 was associated with time 1 anxiety or depression, conduct disorder, and maternal distress; in multivariate analysis, baseline anxiety or depression remained a significant predictor of chronic fatigue. Increased risk for development of fatigue at time 2 was associated with time 1 anxiety or depression, conduct disorder, and older age; in multivariate analyses, these factors and female gender all were significant predictors of fatigue.
  
  
  CONCLUSIONS
  The incidence rates for chronic fatigue and chronic fatigue syndrome in this adolescent sample were relatively high, but the prognosis for these conditions was good. This prospective study provides evidence for an association between emotional/behavioral problems and subsequent onset of fatigue/chronic fatigue.
authors.affiliation: King's College London, Institute of Psychiatry, Section of General Hospital Psychiatry, Weston Education Centre, Cutcombe Rd, London SE5 9RJ, United Kingdom. K.Rimes@iop.kcl.ac.uk
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Rimes
authors.forename: Robert
authors.initials: R
authors.lastname: Goodman
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Howard
authors.initials: H
authors.lastname: Meltzer
authors.forename: Trudie
authors.initials: T
authors.lastname: Chalder
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology*; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D044469:Racial Groups / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology