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Depression in chronic fatigue syndrome
Chronic fatigue syndrome (defined as 3 months of disabling fatigue plus at least one additional symptom persisting after routine tests have failed to identify an obvious underlying cause) is common and challenging to manage. More than half of children and young people are bed bound at some stage and miss one academic term. Depression is often seen and can impact on recovery. Bould and colleagues report the results of a cross sectional survey of depression in chronic fatigue syndrome using the Hospital Anxiety and Depression score (HADS) at assessment in a specialist CFS/ME unit. Depression (>9 HADS) was present in 29% of 542 referrals. Using univariate analysis female gender, poor school attendance, level of fatigue, levels of pain and anxiety were risk factors although duration of illness was not. On multivariate analysis the strongest predictor was disease severity with lower levels of disability associated with lower levels of depression. The authors discuss the importance of screening for, assessing and treating depression in chronic fatigue syndrome and that the level of disability (ie, level of functioning) rather than the duration of symptoms is the most important risk factor. See page 425
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