Chronic fatigue in adolescence--autonomic dysregulation and mental health: an exploratory study.
OBJECTIVE
The present study investigates associations between autonomic cardiovascular dysregulation, psychosocial load and mental health in adolescents presenting with chronic fatigue.


METHODS
Twenty-two adolescents, mean age 15.7 years (12.7-19.1), underwent a clinical mental health examination as part of a broad medical investigation which included autonomic tests. Adolescents and their parents were also interviewed with regard to psychosocial stress factors, family health and previous illnesses. A count of psychosocial load was made for each adolescent based on the interview.


RESULTS
Of 22 fatigued adolescents in the present sample, 14 had psychiatric diagnoses. There was no significant difference in psychosocial load for the fatigued adolescents classified with normal autonomic regulation compared to those with deviant or borderline autonomic regulation. The present psychiatric diagnosis did not differ between the two groups. In a subsample, there was a significant negative association between depressive symptoms and abnormal blood pressure responses during orthostatic challenge.


CONCLUSIONS
No significant psychiatric or psychosocial differences between fatigued adolescents with or without autonomic dysregulation were found in this study. The trends towards higher psychosocial load and greater burden of depressive symptoms in fatigued adolescents with normal autonomic regulation warrant further studies.
Division of Paediatrics, Section for Child and Adolescent Psychiatry, Rikshospitalet University Hospital, 0027 Oslo, Norway. helene.gjone@rikshospitalet.no
Helene
H
Gjone
Vegard Bruun
VB
Wyller
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications; D001794:Blood Pressure; D002319:Cardiovascular System / Q000294:innervation; D016009:Chi-Square Distribution; D002653:Child Behavior Disorders / Q000175:diagnosis; D002908:Chronic Disease; D003863:Depression / Q000150:complications; D005192:Family Health; D005221:Fatigue / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D000297:Psychology, Adolescent; D011593:Psychology, Social; D011594:Psychometrics / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000150:complications