title: Association between school absence and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy.
abstract: OBJECTIVE
  To investigate factors associated with school attendance and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Regional specialist CFS/ME service.
  
  
  METHODS
  Children and young people aged under 18 years.
  
  
  METHODS
  Self-reported school attendance and physical function measured using the physical function subscale of the Short Form 36.
  
  
  METHODS
  Linear and logistic regression analysis of data from self-completed assessment forms on children attending a regional specialist service between 2004 and 2007. Analyses were done in two groups of children: with a completed Spence Children's Anxiety Scale (SCAS) and with a completed Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  Of 211 children with CFS/ME, 62% attended 40% of school or less. In children with completed SCAS, those with better physical function were more likely to attend school (adjusted odds ratio (OR) 1.70; 95% CI 1.36 to 2.13). This was also true for those with completed HADS (adjusted OR 2.05; 95% CI 1.4 to 3.01). Increasing fatigue and pain and low mood were associated with worse physical function. There was no evidence that anxiety, gender, age at assessment, family history of CFS/ME or time from onset of symptoms to assessment in clinic were associated with school attendance or physical function.
  
  
  CONCLUSIONS
  Paediatricians should recognise that reduced school attendance is associated with reduced physical function rather than anxiety. Improving school attendance in children with CFS/ME should focus on evidence-based interventions to improve physical function, particularly concentrating on interventions that are likely to reduce pain and fatigue.
authors.affiliation: Centre for Child and Adolescent Health, University of Bristol, Bristol, UK. esther.crawley@bristol.ac.uk
authors.forename: E
authors.initials: E
authors.lastname: Crawley
authors.forename: J A C
authors.initials: JA
authors.lastname: Sterne
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D000293:Adolescent; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004739:England; D004812:Epidemiologic Methods; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012574:Schools / Q000706:statistics & numerical data*