The course of severe chronic fatigue syndrome in childhood

Little has been reported on prognostic indicators in children with chronic fatigue syndrome (CFS), We used interviews with children and parents, a mea n of 45.5 months after illness onset, to follow up 25 cases of CFS referred to tertiary paediatric psychiatric clinics. At its worst, the illness had been markedly handicapping (prolonged bed-res t and school absence in two-thirds); mean time out of school was one academ ic year. Two-thirds, however, had recovered and resumed normal activities-m ean duration of illness to recovery/assessment 38 months-and none had devel oped other medical conditions. Recovery was associated with specific physic al triggers to the illness, with start of illness in the autumn school term and with higher socioeconomic status. Severe fatigue states in children can cause serious and longlasting handica p but most children recover.