title: Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents.
abstract: Little is known about persistence of or recovery from chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adolescents. Previous studies have small sample sizes, short follow-up or have focused on fatigue rather than CFS/ME or, equivalently, chronic fatigue, which is disabling. This work aimed to describe the epidemiology and natural course of CFS/ME in adolescents aged 13-18 years.
  
  
  
  Longitudinal follow-up of adolescents enrolled in the Avon Longitudinal Study of Parents and Children.
  
  
  
  Avon, UK.
  
  
  
  We identified adolescents who had disabling fatigue of >6 months duration without a known cause at ages 13, 16 and 18 years. We use the term 'chronic disabling fatigue' (CDF) because CFS/ME was not verified by clinical diagnosis. We used multiple imputation to obtain unbiased estimates of prevalence and persistence.
  
  
  
  The estimated prevalence of CDF was 1.47% (95% CI 1.05% to 1.89%) at age 13, 2.22% (1.67% to 2.78%) at age 16 and 2.99% (2.24% to 3.75%) at age 18. Among adolescents with CDF of 6 months duration at 13 years 75.3% (64.0% to 86.6%) were not classified as such at age 16. Similar change was observed between 16 and 18 years (75.0% (62.8% to 87.2%)). Of those with CDF at age 13, 8.02% (0.61% to 15.4%) presented with CDF throughout the duration of adolescence.
  
  
  
  The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years.
authors.affiliation: Centre for Child and Adolescent Health, University of Bristol, Bristol, UK.|School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Norris
authors.affiliation: Centre for Child and Adolescent Health, University of Bristol, Bristol, UK.|School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Collin
authors.affiliation: School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Nuevo
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stansfeld
authors.affiliation: School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jonathan Ac
authors.initials: JA
authors.lastname: Sterne
authors.affiliation: School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Heron
authors.affiliation: Centre for Child and Adolescent Health, University of Bristol, Bristol, UK.|School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Esther
authors.initials: E
authors.lastname: Crawley
mesh_terms: D000293:Adolescent; D004522:Educational Status; D004739:England / Q000453:epidemiology; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011379:Prognosis; D017678:Sex Distribution; D013997:Time Factors
keywords: ALSPAC; Adolescent Health; CFS/ME; Chronic Fatigue Syndrome; Longitudinal