Association between school absence and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy
- 1Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
- 2Department of Social Medicine, University of Bristol, Bristol, UK
- Correspondence to Dr E Crawley, Centre for Child and Adolescent Health, University of Bristol, Hampton House, Cotham Road, Bristol BS6 6JS, UK;
- Accepted 6 October 2008
- Published Online First 11 November 2008
Objective: To investigate factors associated with school attendance and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME).
Design: Cross-sectional study.
Setting: Regional specialist CFS/ME service.
Patients: Children and young people aged under 18 years.
Outcome measures: Self-reported school attendance and physical function measured using the physical function subscale of the Short Form 36.
Methods: Linear and logistic regression analysis of data from self-completed assessment forms on children attending a regional specialist service between 2004 and 2007. Analyses were done in two groups of children: with a completed Spence Children’s Anxiety Scale (SCAS) and with a completed Hospital Anxiety and Depression Scale (HADS).
Results: Of 211 children with CFS/ME, 62% attended 40% of school or less. In children with completed SCAS, those with better physical function were more likely to attend school (adjusted odds ratio (OR) 1.70; 95% CI 1.36 to 2.13). This was also true for those with completed HADS (adjusted OR 2.05; 95% CI 1.4 to 3.01). Increasing fatigue and pain and low mood were associated with worse physical function. There was no evidence that anxiety, gender, age at assessment, family history of CFS/ME or time from onset of symptoms to assessment in clinic were associated with school attendance or physical function.
Implications: Paediatricians should recognise that reduced school attendance is associated with reduced physical function rather than anxiety. Improving school attendance in children with CFS/ME should focus on evidence-based interventions to improve physical function, particularly concentrating on interventions that are likely to reduce pain and fatigue.
Funding The Linbury Trust funded this study.
Competing interests Declared. EC is a medical advisor for the Association for Young People with ME (AYME).