title: Adolescent chronic fatigue syndrome and somatoform disorders: a prospective clinical study.
abstract: OBJECTIVE
  To examine and compare the presenting characteristics and the change in the physical and psychosocial functioning of adolescents with chronic fatigue syndrome (CFS) or somatoform disorders who have received an adaptable multidisciplinary intervention over a 12-month period.
  
  
  METHODS
  Fifty adolescents presenting to the Complex Adolescent Clinic at The Children's Hospital at Westmead, Sydney, Australia were assessed. Their physical and psychosocial functioning was rated by the adolescents and their parents using the Child Health Questionnaire. Participants were assessed at baseline, 4 months and 12 months after initiating treatment. Analyses examined whether diagnosis and/or illness precipitants were related to treatment outcome.
  
  
  RESULTS
  Adolescents with both CFS and somatoform disorders demonstrated improvement in physical and psychosocial functioning over the first 4 months of treatment, sustained at 12-month follow-up. A diagnosis of CFS was associated with poorer physical functioning over time and a trend towards a longer illness time course compared with somatoform disorder. Adjustment for a physical precipitant reduced the association between diagnosis and physical functioning. Those who had a physical precipitant to their illness had significantly poorer physical functioning over time than those who did not, regardless of diagnostic category. Diagnosis and physical precipitant were not associated with psychosocial functioning.
  
  
  CONCLUSIONS
  Improvement in adolescent physical and psychosocial functioning over time suggests that a multidisciplinary treatment model may be effective for varied complex medico-psychosocial presentations, irrespective of diagnosis and illness precipitant. Illness precipitant may have a greater influence on treatment outcome than diagnostic category.
authors.affiliation: Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Klineberg
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rushworth
authors.forename: Helen
authors.initials: H
authors.lastname: Bibby
authors.forename: David
authors.initials: D
authors.lastname: Bennett
authors.forename: Kate
authors.initials: K
authors.lastname: Steinbeck
authors.forename: Susan
authors.initials: S
authors.lastname: Towns
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology / Q000523:psychology*; D000554:Ambulatory Care Facilities; D000704:Analysis of Variance; D001315:Australia; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009788:Occupational Therapy / Q000379:methods; D011446:Prospective Studies; D011584:Psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: adolescent; biopsychosocial approach; chronic fatigue; multidisciplinary treatment; rehabilitation; somatoform disorder