Chronic disabling fatigue at age 13 and association with family adversity.
OBJECTIVE
1) Estimate the prevalence of chronic disabling fatigue at age 13, and 2) investigate associations with early family adversity, using a population-based birth cohort study.


METHODS
The subjects were 10,001 children, of whom 5657 had sufficient data to define chronic disabling fatigue at age 13. Chronic disabling fatigue was defined as tiredness reported by mothers that had lasted for ≥ 3 months or ≥ 6 months, was disabling (school absence or prevented participation in hobbies/sport/leisure activities "quite a lot" or a "great deal"), and not due to another cause. Family adversity was defined by using 14 questions addressing housing, education, social relationships, and maternal health assessed prospectively at birth. We used multiple imputation to correct estimates of prevalence and association for loss to follow-up.


RESULTS
Overall, 1995 teenagers had been tired for the last month, of whom 117 and 53 had chronic disabling fatigue of ≥ 3 and ≥ 6 months' duration, respectively. The estimated prevalence of chronic disabling fatigue of ≥ 3 and ≥ 6 months' duration was 2.07% and 0.94%, respectively, but increased to 2.44% and 1.30%, respectively, after imputing missing data. Prevalence was similar in boys and girls. The risk of chronic disabling fatigue increased with family adversity score (odds ratios: 1.25 [95% confidence interval: 1.09, 1.43] and 1.23 [1.01, 1.51] for ≥ 3 and ≥ 6 months' duration, respectively). Only 36 (30.77%) children with chronic disabling fatigue had consulted a doctor about their fatigue.


CONCLUSIONS
Chronic disabling fatigue is more common in families who experienced early family adversity and is often not reported to health care services.
Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Clifton, Bristol, United Kingdom. esther.crawley@bristol.ac.uk
Esther
E
Crawley
Rachael
R
Hughes
Kate
K
Northstone
Kate
K
Tilling
Alan
A
Emond
Jonathan A C
JA
Sterne
D000293:Adolescent; D002908:Chronic Disease; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005190:Family; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires