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How fatigue is related to other somatic symptoms
  1. E M van de Putte1,
  2. R H H Engelbert2,
  3. W Kuis1,
  4. J L L Kimpen1,
  5. C S P M Uiterwaal3
  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. 3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
  1. Correspondence to:
    Dr E M van de Putte
    KE04.133.1, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Netherlands; E.vandePutte{at}


Aims: To assess the relation between fatigue and somatic symptoms in healthy adolescents and adolescents with chronic fatigue syndrome/myalgic encephalopathy (CFS/ME).

Methods: Seventy two adolescents with CFS were compared within a cross-sectional study design with 167 healthy controls. Fatigue and somatic complaints were measured using self-report questionnaires, respectively the subscale subjective fatigue of the Checklist Individual Strength (CIS-20) and the Children’s Somatization Inventory.

Results: Healthy adolescents reported the same somatic symptoms as adolescents with CFS/ME, but with a lower score of severity. The top 10 somatic complaints were the same: low energy, headache, heaviness in arms/legs, dizziness, sore muscles, hot/cold spells, weakness in body parts, pain in joints, nausea/upset stomach, back pain. There was a clear positive relation between log somatic symptoms and fatigue (linear regression coefficient: 0.041 points log somatic complaints per score point fatigue, 95% CI 0.033 to 0.049) which did not depend on disease status.

Conclusions: Results suggest a continuum with a gradual transition from fatigue with associated symptoms in healthy adolescents to the symptom complex of CFS/ME.

  • CDC, Centers for Disease Control and Prevention
  • CFS, chronic fatigue syndrome
  • CIS-20, Children’s Somatization Inventory
  • ME, myalgic encephalopathy
  • chronic fatigue syndrome
  • fatigue
  • somatic complaints
  • adolescence
  • healthy

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