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Chronic fatigue syndrome and health control in adolescents and parents
  1. E M van de Putte1,
  2. R H H Engelbert2,
  3. W Kuis1,
  4. G Sinnema3,
  5. J L L Kimpen1,
  6. C S P M Uiterwaal4
  1. 1Department of Paediatrics, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, Netherlands
  2. 2Department of Paediatric Physical Therapy and Paediatric Exercise Physiology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, Netherlands
  3. 3Department of Paediatric Psychology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, Netherlands
  4. 4Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
  1. Correspondence to:
    Dr E M van de Putte
    KE04.133.1, Wilhelmina Children’s Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Netherlands;


Aims: To explore the locus of health control in adolescents with chronic fatigue syndrome (CFS) and their parents in comparison with healthy adolescents and their parents.

Methods: In this cross-sectional study 32 adolescents with CFS were compared with 167 healthy controls and their respective parents. The Multidimensional Health Locus of Control (MHLC) questionnaire was applied to all participants.

Results: There was significantly less internal health control in adolescents with CFS than in healthy controls. An increase of internal health control of one standard deviation was associated with a 61% reduced risk for CFS (OR = 0.39, 95% CI 0.25 to 0.61). Internal health control of the parents was also protective (OR fathers: 0.57 (95% CI 0.38 to 0.87); OR mothers: 0.74 (95% CI 0.50 to 1.09)). The external loci of health control were higher in adolescents with CFS and in their parents. Increased levels of fatigue (56%) were found in the mothers of the adolescents with CFS, in contrast with the fathers who reported a normal percentage of 13.

Conclusions: In comparison with healthy adolescents, adolescents with CFS and their parents show less internal health control. They attribute their health more to external factors, such as chance and physicians. This outcome is of relevance for treatment strategies such as cognitive behaviour therapy, for which health behaviour is the main focus.

  • locus of control
  • chronic fatigue syndrome
  • illness beliefs
  • illness behaviour
  • family interactions

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  • Competing interests: none

  • Published Online First 27 July 2005