Abstract
Severe chronic fatigue syndromes are rare in childhood. Two severely affected children are described, one presenting in an extreme withdrawal state. Possible psychopathological mechanism are discussed including the relevance of viral illnesses, depressive symptoms, characteristic child personality and family relationship. These mechanisms are comparable to those described for other functional somatic problems of childhood, suggesting their general relevance in the maintenance of the somatization of distress in childhood. Treatment strategies are described which resulted in recovery in both cases.
Résumé
Les syndromes de fatique sévère sont rares dans l'enfance. Deux enfants sévèrement atteints sont décrits, un présentant und dgeré de retrait extreme. Les mécanismes psychopathologiques possibles sont discutés y compris l'opportunité de maladies virales de symptômes dépressifs ainsi que les caractéristiqué de la personnalité de l'enfant et des relations familiales. Ces mécanismes sont comparables à ceux décrits pour d'autres problèmes somatiques fonctionnels de l'enfance suggérant leur adéquation générale dans le maintien de la somatisation de la détresse dans l'enfance. Les stratégies thérapeutiques sont décrities, qui ont abouti à la guérison dans les deux cas.
Zusammenfassung
Schwere “Chronic Fatigue Syndrome” sind im Kindesalter selten. Wir beschreiben zwei schwer betroffene Kinder, wobei eines ein ausgeprägtes Rückzugsverhalten zeigte. Mögliche psychopathologische Mechanismen werden diskutiert, u. a. Viruserkrankungen, depressive Symptome, charakteristische kindliche Persönlichkeit und familiäre Beziehungen,. Diese Mechanismen sind mit anderen funktionellen somatischen Störungen im Kindesalter vergleichbar und deuten auf deren allgemeine Relevanz für die Aufrechterhalung von Somatisierungen in Folge von seelischer Belastung hin. Die therapeutischen Vorgehensweisen werden beschrieben, die in beiden Fällen zur Heilung führten.
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References
Bass, C. (1989). Fatigue states.British Journal of Hospital Medicine, 41, 315.
Butler, S., Chalder, T., Ron, M., & Wessely, S. (1991). Cognitive Behavioral Therapy in the Chronic Fatigue Syndrome.Journal of Neurology, Neurosurgery & Psychiatry, 54, 153–158.
Cantwell, D. P. (1983). Depression in Childhood: Clinical Picture and Diagnostic Criteria. In Cantwell, D. P. & Carlson, G. A. (Eds.),Affective Disorders in Childhood and adolescence. Lancaster: MTP Publications.
David, A., Pelosi, A., McDonald, E., Stephens, D., Ledger, D., Rathbone, R. & Mann, A. (1990). Tired, weak, or in need or rest: fatigue amonggeneral practice attenders.British Medical Journal., 301, 1199–1202.
Dillon, M. J. (1978). ‘Epdiemic neuromyasthenia’ at The Hospital for Sick Children, Great Ormond Street, London.Postgraduate Medical Journal, 54, 725–730.
Dubowitz, V. & Hersov, L. (1976). Management of children with non-organic (hysterical) disorders of motor function.Developmental Medicine and Child Neurology, 18, 358–368.
Garralda, M. E. & Bailey, D. (1987). Psychosomatic Aspects of Childrens's Consultations in Primary Care.European Archives of Psychiatry & Neurological Sciences, 236, 319–322.
Garralda, M. E. & Bailey, D. (1990). Paediatrician Identification of Psychological Factors Associated with General Paediatric Consultations.Journal of Psychosomatic Research, 34, 303–312.
Grattan-Smith, P., Fairley, M. & Procopis, P. (1988). Clinical features of conversion disroder.Archives of Disease in Childhood, 63, 408–414.
Hickie, I., Lloyd, A. Wakefield, D. &Parker, G. (1990). The Psychiatric Status of Patients with the Chronic Fatigue Syndrome.British Journal of Psychiatry, 156, 534–540.
ICD-9. World Health Organization (WHO) (1978).Mental Disorders: Glossary and Guide to the Classification in accordance with the 9th Revision of the International Classification of Diseases. Geneva: WHO.
Klein, R. G. & Last, C. G. (1989).Anxiety Disoders in Children. Sage: London.
Kroenke, K., Wood, D. R., Mangeldorff, D., Meier, N. J. & Powell, J. B. (1988). Chronic Fatigue in Primary Care: Prevalence, Patient Characteristics, and Outcome.Journal of the American Medical Association, 260, 929–934.
Lask, B. (1986). The high-achieving child.Postgraduate Medical Journal., 62, 143–145.
Lask, B. & Dillon, M. (1990). Postviral fatigue syndrome.Archives of Disease in Childhood, 65, 1198.
Leslie, S. A. (1988). Diagnosis and treatment of hystercial conversion reactions.Archives of Disease in Childhood, 63, 506–511.
May, P. G. R., Donnan, S. P. B., Ashton, J. R., Ogilvie, M. M. & Rolles, C. J. (1980). Personality and medical Perception in Benign Myalgic EncephalomyelitisLancet, II, 1122–1124.
Meijer, A., Zakay-Rones, Z. & Morag, A. (1988). Postinfluenzal psychiatric disorder in adolescents.Acta Psychiatrica Scandinavica, 78, 176–181.
Minuchin, S., Baker, L. M., Rosman, B. L., Liebman, R., Milman, L. & Todd, T. C. (1975). A conceptual model of psychosomatic illness in childrenArchives of General Psychiatry, 32, 1031–1038.
Riley, M. S., O'Brien, C. J., MaClusky, D. R., Bell, N. P. & Nicholls, D. P. (1990). Aerobic work capacity in patients with chronic fatigue syndrome.British Medical Journal, 302, 953–956.
Rosen, S. D., King, J. C., Wilkinson, J. B. & Nixon, P. G. F. (1990). Is chronic fatiuge syndrome synonymous with effort syndrome?Journal of the Royal Society of Medicine, 83, 761–764.
Sharp, M. C. et al.. (1991). A report. Chronic fatigue syndrome: guidelines for research.Journal of the Royal Society of Medicine, 84, 118–121.
Taylor, D. C. (1986). Hyteria, play acting and courage.British Journal of Psychiatry, 149, 37–41.
Volkmar, R. R., Poll, J. & Lewis, M. (1984). Conversion Reactions in Childhood and Adolescence.Journal of the American Academy of Child Psychiatry, 23, 424–430.
Wessely, S. (1990). Old wine in new bottles: neuraschenia and “ME”.Psychological Medicine, 20, 35–53.
Wessely, S. & Powell, R. (1989). Fatiuge syndromes: a comparison of chronic “post-viral” fatigue with neuromuscular and affective dissorder.Journal of Neurology Neurosurgery and Psychiatry, 32, 940–948.
White, P. (1989). Fatigue syndromes: neurasthenia revisited.British Medical Journal, 298, 1199–1120.
Wilson, P. M. Y. et al. (1989). Features of Coxsackie B Virus (CBV) Infection in Children with Prologned Physical and Psychological Morbidity.Journal of Psychosomatic Research, 33, 29–36.
Yousef, G. E., Mann, G. F., Smith, D. G., Bell, E. J. Murugesan, V., McCartney & Mowbray, J. F. (1988). Chronic Enterovirus Infection in Patients with Postviral Syndrome.The Lancet, 1, 146–150.
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Garralda, M.E. Severe chronic fatigue syndrome in chidhood: A discussion of psychopathological mechanisms. European Child & Adolescent Psychiatry 1, 111–118 (1992). https://doi.org/10.1007/BF02091794
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DOI: https://doi.org/10.1007/BF02091794