The impact of chronic fatigue syndrome on cognitive functioning in adolescents.
Chronic fatigue syndrome (CFS) is characterized by persistent fatigue and severe disability. Most adolescent patients report attention and concentration problems, with subsequent poor performance at school. This study investigated the impact of CFS on intellectual capacity by (1) assessing discrepancies between current intelligence quotient (IQ) and school level and (2) exploring differences in current IQ and pre-CFS school performance, compared with healthy individuals. Current data was cross-sectionally gathered and compared with retrospective pre-CFS school performance data. Fifty-nine CFS adolescents and 40 controls were evaluated on performance on age-appropriate intelligence tests and school level. Current IQ scores of CFS adolescents were lower than expected on the basis of their school level. Furthermore, there was a difference in intelligence performance across time when current IQ scores were compared with pre-CFS cognitive achievement. Healthy controls did not show any discrepancies.


CONCLUSIONS
According to their pre-CFS intelligence assessments, CFS patients started with appropriate secondary school levels at the age of 12. Our data suggest that CFS may be accompanied by a decline in general cognitive functioning. Given the critical age for intellectual development, we recommend a timely diagnosis followed by appropriate treatment of CFS in adolescents.


BACKGROUND
Adolescent chronic fatigue syndrome (CFS) is a debilitating condition with major impact on social and intellectual development. Most patients report concentration problems, with subsequent poor performance at school. Little is known about the influence of CFS on intellectual performances.


BACKGROUND
IQ scores of CFS adolescents are lower than the IQ scores of healthy peers with an equivalent school level. There is a decrease in intelligence performance across time when current IQ scores are compared with pre-CFS cognitive achievement. Healthy controls do not show any discrepancies between their current IQ, school level and previous cognitive functioning. This suggest that adolescent CFS may be accompanied by a decline in general cognitive functioning.
Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, HP KE.04.133.1, Post box 85090, 3508 AB, Utrecht, The Netherlands. L.N.Nijhof@umcutrecht.nl.
Linde N
LN
Nijhof
Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, HP KE.04.133.1, Post box 85090, 3508 AB, Utrecht, The Netherlands. S.L.Nijhof@umcutrecht.nl.
Sanne L
SL
Nijhof
Expert Center Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Gijs.Bleijenberg@radboudumc.nl.
Gijs
G
Bleijenberg
Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. R.K.Stellato@umcutrecht.nl.
Rebecca K
RK
Stellato
Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, HP KE.04.133.1, Post box 85090, 3508 AB, Utrecht, The Netherlands. J.Kimpen@umcutrecht.nl.
Jan L L
JL
Kimpen
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands. H.E.Hulshoff@umcutrecht.nl.
Hilleke E
HE
Hulshoff Pol
Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, HP KE.04.133.1, Post box 85090, 3508 AB, Utrecht, The Netherlands. E.vandePutte@umcutrecht.nl.
Elise M
EM
van de Putte
D000293:Adolescent; D002648:Child; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007360:Intelligence / Q000502:physiology*; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D012574:Schools
Adolescent; Chronic fatigue syndrome; Cognitive impairment; IQ; School performance