title: Chronic Fatigue Syndrome at Age 16 Years.
abstract: BACKGROUND
  In the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, chronic disabling fatigue lasting ≥6 months affected 1.3% of 13-year-olds, was equally common in boys and girls, and became more prevalent with increasing family adversity.
  
  
  METHODS
  ALSPAC data were used to estimate the prevalence of chronic fatigue syndrome (CFS) at age 16 years, defined by parental report of unexplained disabling fatigue lasting ≥6 months. We investigated gender and a composite 14-item family adversity index as risk factors. School absence data were obtained from the National Pupil Database. Multiple imputation was used to address bias caused by missing data.
  
  
  RESULTS
  The prevalence of CFS was 1.86% (95% confidence interval [CI]: 1.47 to 2.24). After excluding children with high levels of depressive symptoms, the prevalence was 0.60% (95% CI: 0.37 to 0.84). Authorized school absences were much higher (mean difference: 35.6 [95% CI: 26.4 to 44.9] half-day sessions per academic year) and reported depressive symptoms were much more likely (odds ratio [OR]: 11.0 [95% CI: 5.92 to 20.4]) in children with CFS than in those without CFS. Female gender (OR: 1.95 [95% CI: 1.33 to 2.86]) and family adversity (OR: 1.20 [95% CI: 1.01 to 1.42] per unit family adversity index) were also associated with CFS.
  
  
  CONCLUSIONS
  CFS affected 1.9% of 16-year-olds in a UK birth cohort and was positively associated with higher family adversity. Gender was a risk factor at age 16 years but not at age 13 years or in 16-year-olds without high levels of depressive symptoms.
authors.affiliation: School of Social & Community Medicine and Centre for Child & Adolescent Health, University of Bristol, Bristol, United Kingdom.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Collin
authors.affiliation: School of Social & Community Medicine and Centre for Child & Adolescent Health, University of Bristol, Bristol, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Norris
authors.affiliation: School of Social & Community Medicine and Centre for Child & Adolescent Health, University of Bristol, Bristol, United Kingdom.
authors.forename: Roberto
authors.initials: R
authors.lastname: Nuevo
authors.affiliation: School of Social & Community Medicine and.
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.affiliation: School of Social & Community Medicine and Centre for Child & Adolescent Health, University of Bristol, Bristol, United Kingdom.
authors.forename: Carol
authors.initials: C
authors.lastname: Joinson
authors.affiliation: School of Social & Community Medicine and.
authors.forename: Jonathan A C
authors.initials: JA
authors.lastname: Sterne
authors.affiliation: School of Social & Community Medicine and Centre for Child & Adolescent Health, University of Bristol, Bristol, United Kingdom esther.crawley@bristol.ac.uk.
authors.forename: Esther
authors.initials: E
authors.lastname: Crawley
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D054541:Family Conflict; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology