title: Adolescent chronic fatigue syndrome: prevalence, incidence, and morbidity.
abstract: OBJECTIVE
  To determine nationwide general practitioner (GP)-diagnosed prevalence and pediatrician-diagnosed incidence rates of adolescent chronic fatigue syndrome (CFS), and to assess CFS morbidity.
  
  
  METHODS
  We collected data from a cross-sectional national sample among GPs and prospective registration of new patients with CFS in all pediatric hospital departments in the Netherlands.
  
  
  METHODS
  Study participants were adolescents aged 10 to 18 years. A representative sample of GPs completed questionnaires on the prevalence of CFS in their adolescent patients. Pediatric hospital departments prospectively reported new cases of CFS in adolescent patients. For every new reported case, a questionnaire was sent to the reporting pediatrician and the reported patient to assess CFS morbidity. Prevalence was estimated through the data from GP questionnaires and incidence was estimated on the basis of cases newly reported by pediatricians from January to December 2008.
  
  
  RESULTS
  Prevalence was calculated as 111 per 100 000 adolescents and incidence as 12 per 100 000 adolescents per year. Of newly reported patients with CFS, 91% scored at or above cutoff points for severe fatigue and 93% at or above the cutoff points for physical impairment. Forty-five percent of patients with CFS reported >50% school absence during the previous 6 months.
  
  
  CONCLUSIONS
  Clinically diagnosed incidence and prevalence rates show that adolescent CFS is uncommon compared with chronic fatigue. The primary adverse impact of CFS is extreme disability associated with considerable school absence.
authors.affiliation: Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands. s.l.nijhof@umcutrecht.nl
authors.forename: Sanne L
authors.initials: SL
authors.lastname: Nijhof
authors.forename: Kimberley
authors.initials: K
authors.lastname: Maijer
authors.forename: Gijs
authors.initials: G
authors.lastname: Bleijenberg
authors.forename: Cuno S P M
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Jan L L
authors.initials: JL
authors.lastname: Kimpen
authors.forename: Elise M
authors.initials: EM
authors.lastname: van de Putte
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology*; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D058006:General Practice; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010372:Pediatrics; D015995:Prevalence; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires