A comparison of individual and family psychology of adolescents with chronic fatigue syndrome, rheumatoid arthritis, and mood disorders

Chronic fatigue syndrome (CFS) is a controversial diagnosis with unknown ca use. Adult studies indicate high rates of psychosocial dysfunction and psyc hiatric comorbidity. The authors compared three groups of pediatric patient s selected by diagnosis-(1) CFS (n = 15), (2) juvenile rheumatoid arthritis (n = 15), and (3) mood disorders (n = 15)-across many psychological measur es. CFS subjects had dramatic elevation of the Somatic Complaints subscale (mean T score = 75), whereas the mood disorders group had higher externaliz ing scores (mean T score = 68) on the Child Behavior Checklist. The CFS sub jects missed significantly more school compared with the two control groups . After the onset of CFS, 13 of 15 of the CFS patients required significant educational accommodation. Only 4 of the 15 CFS patients had an Axis I psy chiatric diagnosis, as determined by the Computerized Diagnostic Interview for Children. Despite a low rate of psychiatric diagnosis in the CFS sample , these data attest to their psychosocial and school dysfunction.