BMJ Paediatr Open. 2018 Mar 16;2(1):e000233. doi: 10.1136/bmjpo-2017-000233. eCollection 2018.
Systemic exertion intolerance disease diagnostic criteria applied on an adolescent chronic fatigue syndrome cohort: evaluation of subgroup differences and prognostic utility.
BMJ paediatrics open
Tarjei Tørre Asprusten, Dag Sulheim, Even Fagermoen, Anette Winger, Eva Skovlund, Vegard Bruun Wyller
Affiliations
Affiliations
- Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.
- Department of Pediatrics and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
- Department of Anesthesiology and Critical Care, Oslo University Hospital, Oslo, Norway.
- Department of Nursing and Health Promotion, Oslo University College of Applied Sciences, Oslo, Norway.
- Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Pharmacoepidemiology, Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
- Department of Pediatrics and Adolescent Medicine, Akershus University Hospital, Akershus, Norway.
PMID: 29637195
PMCID: PMC5887832 DOI: 10.1136/bmjpo-2017-000233
Abstract
OBJECTIVE: Existing case definitions for chronic fatigue syndrome (CFS) all have disputed validity. The present study investigates differences between adolescent patients with CFS who satisfy the systemic exertion intolerance disease (SEID) diagnostic criteria (SEID-positive) and those who do not satisfy the criteria (SEID-negative).
METHODS: 120 adolescent patients with CFS with a mean age of 15.4 years (range 12-18 years) included in the NorCAPITAL project (ClinicalTrials ID: NCT01040429) were post-hoc subgrouped according to the SEID criteria based on a comprehensive questionnaire. The two subgroups were compared across baseline characteristics, as well as a wide range of cardiovascular, inflammatory, infectious, neuroendocrine and cognitive variables. Data from 30-week follow-up were used to investigate prognostic differences between SEID-positive and SEID-negative patients.
RESULTS: A total of 45 patients with CFS were SEID-positive, 69 were SEID-negative and 6 could not be classified. Despite the fact that clinically depressed patients were excluded in the NorCAPITAL project, the SEID-positive group had significantly higher score on symptoms suggesting a mood disorder (Mood and Feelings Questionnaire): 23.2 vs 13.4, difference 9.19 (95% CI 5.78 to 12.6). No other baseline characteristics showed any group differences. When accounting for multiple comparisons, there were no statistically significant differences between the groups regarding cardiovascular, inflammatory, infectious, neuroendocrine and cognitive variables. Steps per day and Chalder Fatigue Questionnaire at week 30 showed no differences between the groups.
CONCLUSION: The findings question the discriminant and prognostic validity of the SEID diagnostic criteria in adolescent CFS, and suggest that the criteria tend to select patients with depressive symptoms.
Keywords: adolescent health; chronic fatigue syndrome
Conflict of interest statement
Competing interests: None declared.
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