Association between school absence and physical function in paediatric CFS/ME

Abstract

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 <18.

Outcome measures: Self reported school attendance and physical function measured using the physical function subscale of the SF36.

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: (1) with a completed Spence Children’s Anxiety Scale (SCAS) and (2) 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 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, 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.