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A Follow-up Study

Anna C. Gill, MBBS; Ana Dosen, MBBS, FRACP; John B. Ziegler, MBBS, FRACP, MD

Arch Pediatr Adolesc Med. 2004;158:225-229.

Objectives  To compare the frequency of persistent symptoms up to 8 years after illness onset in adolescents diagnosed as having chronic fatigue syndrome, idiopathic chronic fatigue, and unexplained fatigue for less than 6 months, and to determine if hospital admission is associated with outcome.

Design  A cohort study using questionnaire follow-up.

Setting  A tertiary referral hospital.

Patients  Consecutive adolescents referred for assessment of persistent fatigue were identified and retrospectively divided into 3 groups according to the diagnostic criteria for chronic fatigue syndrome and idiopathic chronic fatigue.

Intervention  A questionnaire was designed and administered by telephone at a mean of 4.57 years after the initial examination.

Main Outcome Measure  The persistence of self-reported symptoms was compared with respect to patient group and admission.

Results  Outcome data were obtained for 34 (69%) of the 49 eligible subjects. Twenty-five percent of the chronic fatigue syndrome group showed near to complete improvement, 31% showed partial improvement, and 44% showed no improvement. The idiopathic chronic fatigue group had near to complete recovery in 50%, partial in 10%, and no improvement in 40%. Those with unexplained fatigue for less than 6 months had all recovered. There was no difference between the outcome of the subjects admitted to the hospital and those managed as outpatients.

Conclusions  Adolescents with less than 6 months of fatigue have a good outcome. Unexplained fatigue lasting more than 6 months has a similar outcome regardless of the presence of minor criteria for chronic fatigue syndrome.

From the Departments of General Pediatrics (Drs Gill and Dosen) and Immunology, Allergy, and Infectious Diseases (Dr Ziegler), Sydney Children's Hospital, Sydney, Australia.

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