European Journal of Pediatrics

, Volume 172, Issue 10, pp 1293–1298

Clinical Practice: Chronic fatigue syndrome

  • Charlotte L. Werker
  • Sanne L. Nijhof
  • Elise M. van de Putte

DOI: 10.1007/s00431-013-2058-8

Cite this article as:
Werker, C.L., Nijhof, S.L. & van de Putte, E.M. Eur J Pediatr (2013) 172: 1293. doi:10.1007/s00431-013-2058-8


The diagnosis chronic fatigue syndrome (CFS) was conceptualized in the mid-1980s. It is a clinically defined condition characterized by severe and disabling new onset fatigue with at least four additional symptoms: impaired memory or concentration, sore throat, tender cervical or axillary lymph nodes, muscle pain, multi-joint pain, new headaches, unrefreshing sleep or post-exertion malaise. Chronic fatigue syndrome in adolescents is a rare condition compared to symptomatic fatigue. The estimated prevalence of adolescent CFS ranges between 0.11 and 1.29 % in Dutch, British, and US populations. Diagnosis of the chronic fatigue syndrome is established through exclusion of other medical and psychiatric causes of chronic fatiguing illness. Taking a full clinical history and a full physical examination are therefore vital. In adolescence, CFS is associated with considerable school absence with long-term detrimental effects on academic and social development. One of the most successful potential treatments for adolescents with CFS is cognitive behavioural therapy, which has been shown to be effective after 6 months in two thirds of the adolescents with CFS. This treatment effect sustains at 2–3-year follow-up. In conclusion, the diagnosis CFS should be considered in any adolescent patient with severe disabling long-lasting fatigue. Cognitive behavioural therapy is effective in 60–70 % of the patients. Prompt diagnosis favours the prognosis.


Chronic fatigue syndrome Chronic fatigue Adolescents Cognitive behavioural therapy Prevalence 



Cognitive behavioural therapy


Centre for Disease Control and Prevention


Chronic fatigue syndrome

UMC Utrecht

University Medical Centre Utrecht

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Charlotte L. Werker
    • 1
  • Sanne L. Nijhof
    • 1
  • Elise M. van de Putte
    • 1
    • 2
  1. 1.Department of Pediatrics, Wilhelmina Children’s Hospital, University Medical Centre UtrechtUtrechtThe Netherlands
  2. 2.Department of PediatricsUniversity Medical Centre UtrechtUtrechtThe Netherlands

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