The definition of disabling fatigue in children and adolescents.
The definition of disabling fatigue in children and adolescents.
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DOI：
10.1186/1471-2296-6-33
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发表时间：
2005-08-09
影响因子：
2.9
通讯作者：
Farmer, Anne
中科院分区：
文献类型：
--
作者：
Fowler, Tom;Duthie, Pamela;Farmer, Anne
背景：致残性疲劳是导致长期缺课的主要疾病相关原因。虽然有公认的标准诊断慢性疲劳的成年人，它仍然不确定如何最好地定义致残性疲劳和慢性疲劳综合征（CFS）的儿童和青少年。在这项以人群为基础的研究中，目的是确定儿童谁经历了一段时间的致残性疲劳和检查的临床和人口统计学差异之间的个人谁履行了一个狭窄的定义致残fatigue和那些谁履行了更广泛的定义致残fatigue.METHODS：参与者（年龄8-17岁）被确定从人口为基础的双登记。家长报告被用来确定儿童谁曾经历过一段时间的致残性疲劳。然后对这些受影响儿童的父母进行标准化的电话采访。对临床和人口统计学特征的数据进行了检查，包括发病年龄、性别、每周受影响的天数、每天休息的时间、缺课、抑郁症的合并症和疲劳所致损害的总体指标。狭义定义为至少6个月的致残性疲劳加上至少4种相关症状，这与成人CFS的操作标准相当。更广泛的定义包括那些至少有3个月的致残性疲劳和4个或更多的相关症状，以及那些简单的至少3个月的致残性疲劳。组是相互exclusive.Results：1468个家庭（65%的响应率）和电话采访完成了99个129名参与者（77%）谁经历了疲劳的问卷返回。符合狭义定义的患者和符合广义定义的患者在人口统计学和临床特征或损伤程度方面没有显著差异。唯一的例外是报告的儿童每周受疲劳影响的天数。所有组表现出证据的实质性损害与fatigue.CONCLUSION：儿童和青少年谁不符合目前的CFS的狭义定义，但患有致残性疲劳表现出可比性和实质性损害。在初级保健环境中，更广泛的致残性疲劳定义将有助于识别需要支持的受损儿童和青少年。
BACKGROUND: Disabling fatigue is the main illness related reason for prolonged absence from school. Although there are accepted criteria for diagnosing chronic fatigue in adults, it remains uncertain as to how best to define disabling fatigue and Chronic Fatigue Syndrome (CFS) in children and adolescents. In this population-based study, the aim was to identify children who had experienced an episode of disabling fatigue and examine the clinical and demographic differences between those individuals who fulfilled a narrow definition of disabling fatigue and those who fulfilled broader definitions of disabling fatigue.METHODS: Participants (aged 8-17 years) were identified from a population-based twin register. Parent report was used to identify children who had ever experienced a period of disabling fatigue. Standardised telephone interviews were then conducted with the parents of these affected children. Data on clinical and demographic characteristics, including age of onset, gender, days per week affected, hours per day spent resting, absence from school, comorbidity with depression and a global measure of impairment due to the fatigue, were examined. A narrow definition was defined as a minimum of 6 months disabling fatigue plus at least 4 associated symptoms, which is comparable to the operational criteria for CFS in adults. Broader definitions included those with at least 3 months of disabling fatigue and 4 or more of the associated symptoms and those with simply a minimum of 3 months of disabling fatigue. Groups were mutually exclusive.RESULTS: Questionnaires were returned by 1468 families (65% response rate) and telephone interviews were completed on 99 of the 129 participants (77%) who had experienced fatigue. There were no significant differences in demographic and clinical characteristics or levels of impairment between those who fulfilled the narrower definition and those who fulfilled the broader definitions. The only exception was the reported number of days per week that the child was affected by the fatigue. All groups demonstrated evidence of substantial impairment associated with the fatigue.CONCLUSION: Children and adolescents who do not fulfil the current narrow definition of CFS but do suffer from disabling fatigue show comparable and substantial impairment. In primary care settings, a broader definition of disabling fatigue would improve the identification of impaired children and adolescents who require support.