Table 1.
Summary of research included.
| Title/authors | Objective | Intervention | Participants | Country | Method | Key findings |
|---|---|---|---|---|---|---|
| Biofeedback and cognitive behavioral therapy for Egyptian adolescents suffering from chronic fatigue syndrome; Al-Haggar et al. (2006) | Evaluate the efficacy of CBT with biofeedback in adolescents with CFS | RCT | 92 adolescents (mean age 12.52 ± 3.32 years) | Egypt | CBT aided by biofeedback intervention group versus control group. Assessed post-intervention: fatigue, school attendance, CFS symptoms | Fatigue severity was significantly lower and school attendance significantly higher in intervention group compared to the control group. Self-reported decreased in intervention group |
| Chronic fatigue syndrome: an evaluation of a community based management programme for adolescents and their families; Ashby et al. (2006) | Assess community-based programme | N/A | 10 children and adolescents (8–16 years old) and their parents | United Kingdom | Semi-structured interviews | Positive feedback of the approach conducted to include the family within the programme |
| Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis is different in children compared to in adults: a study of UK and Dutch clinical cohorts; Collin et al. (2015) | Examine differences between young children, adolescents and adults with CFS | N/A | United Kingdom (2004–2014) and the Netherlands (2008–2010) database; 1568 United Kingdom adolescents (12–18 years) and 210 (under 12); 135 Dutch adolescents | United Kingdom and the Netherlands | Investigation of clinical cohorts from the United Kingdom and RCT from the Netherlands; multiple outcome measures | Younger aged children had less of a gender imbalance. Differences in elevated symptoms and range of symptoms depending on the age |
| Chronic fatigue syndrome at age 16 years; Collin et al. (2015) | Estimate the prevalence of CFS at 16 years of age | N/A | 14,541 pregnancies and 13,978 children alive at 12 months of age (excluding triplets and quads) | United Kingdom | ALSPAC data to estimate the prevalence of CFS at age 16. Used parent report of unexplained disabling fatigue lasting ≥six months; ALSPAC Family Adversity Index; school absence data |
Family adversity created higher risk of diagnosis of CFS. Female gender posed higher risk at 16 years of age as well as other mental health concerns |
| Maternal and childhood psychological factors predict chronic disabling fatigue at age 13 years; Collin et al. (2015) | Investigate if premorbid maternal and childhood psychological problems are risk factors for CFS at age 13 | N/A | 110 children of 5657 by age 13; data from the Avon Longitudinal Study of Parents and Children | United Kingdom | Edinburgh Postnatal Depression Scale and the Crown-Crisp Experiential Index at multiple time points | Mental health of both child and mother is a risk factor for CFS |
| Comparing specialist medical care with specialist medical care plus the Lightning Process® for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised control trial (SMILE Trial); Crawley et al. (2013) | Examine the effectiveness of Lightning Process to Standard medical care and details on implementation | RCT | 80 participants (12–18 years old) | United Kingdom | RCT: Standard medical care or Standard medical care plus Lightning Process; primary outcomes are physical function (SF-36 physical function short form) and fatigue (Chalder Fatigue Scale) | Ongoing |
| Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for pediatric chronic fatigue syndrome: randomized control trial; Crawley et al. (2017) | Compare effectiveness and cost-effectiveness of Lightning Process plus specialist medical care to Standard medical care alone in children with CFS/ME | RCT | 100 participants (12–18 years old) | United Kingdom | Measured at multiple times (3, 6 and 12 months). Primary outcome measure: SF-36-PFS (six months). Secondary measures: pain, anxiety, depression, school attendance and cost-effectiveness from health service viewpoint (3, 6 and 12 months) |
Lightning Process plus Standard medical care improved physical function, fatigue, decreased anxiety and depression, and improved school attendance. This was after 6 and 12 months. Cost-effective for mild to moderately affected adolescents in relation to health-related quality of life. Not all children wanted to take part and the reasons were not known |
| A multidimensional treatment plan for chronic fatigue syndrome; Gibson and Gibson (1999) | Test validity of multi-therapeutic treatment for people with CFS | Treatment-dietary intervention | 64 participants completed (10–59 years old) | United Kingdom | Six-month treatment intervention; intervention-wheat-free diet with nutritional supplements; homeopathic treatment of allergies; homeopathic constitutional prescribing; psychotherapy | 70% benefited wheat-free diet and supplements most helpful |
| Graduated exercise training and progressive training in adolescents with chronic fatigue syndrome: a randomized controlled pilot study; Gordon and Knapman (2010) | Effects of aerobic graded exercise and progressive resistance training on exercise intolerance, fatigue and quality of life | RCT | 22 participants (aged 13–18) | Australia | Measures: exercise tolerance, metabolic equivalents, quality of life, muscular strength and endurance. Evaluation of depressive symptoms and fatigue severity |
No significant difference between groups. Improvement in physical capacity and quality of life. Fatigue severity and depressive symptoms only improved in aerobic training group |
| Promising outcomes of an adolescent chronic fatigue syndrome inpatient programme; Gordon and Lubitz (2009) | Impact of graded exercise programme on physical outcomes, fatigue and mental state | Exercise programme assessment | 16 participants (mean age: 16.2 ± 1.28 years) | Australia | Outcome measures: quality of life, fatigue and depression; exercise assessment pre and post-treatment | GET significantly improves aerobic capacity. Improvement in depression scores. Fatigue severity improved |
| A qualitative investigation of eating difficulties in adolescents with chronic fatigue syndromes/myalgic encephaliomyelitis; Harris et al. (2017) | Exploring impact of eating difficulties in children with CFS | N/A | 11 participants (aged 12–17 years) | United Kingdom | Semi-structured interviews; thematic analysis | Difficulties caused by being too fatigued, low mood to eat and changes to their taste and smell. Variety of adaptations to ease difficulties |
| Early Adverse Experience and Risk for Chronic Fatigue Syndrome; Heim et al. (2006) | Investigate the relationship between early adverse experience and risk for CFS | N/A | 43 individuals with CFS and 60 healthy Control participants (73 total) (18–69 years old) | United States | Self-reported childhood trauma and psychopathology | Higher response of childhood trauma from those with CFS/ME. Childhood trauma increased severity of symptoms in those with CFS/ME |
| Interventions in pediatric chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review; Knight et al. (2013) | Systematic review of literature on interventions for paediatric CFS/ME | N/A | Children and/or adolescents (<18 years of age) | N/A | PRISMA guidelines for systematic review; databases searched: CINAHL, PsycINFO and Medline; 24 papers on 21 studies were included | Strongest evidence for CBT. Only one study examining exercise therapy in isolation. No evidence of detrimental impact of exercise as therapy. Lack of research in efficacy and safety of pharmaceutical or immunological treatment |
| A review of the predisposing, precipitating and perpetuating factors in chronic fatigue syndrome in children and adolescents; Lievesley et al. (2014) | Review of CFS in children and adolescents | N/A | N/A | N/A | Narrative synthesis; multiple databases searched; published articles from 1980 to 2013 | Psychiatric comorbidity higher in young people with CFS compared to healthy controls. Infection prior to diagnosis. Psychological and social risk factors (e.g., family history of CFS) had mixed results |
| Chronic fatigue syndrome: successful outcome of an intensive inpatient programme; Lim and Lubitz (2002) | Study the outcome of an intensive multidisciplinary inpatient programme | Multidisciplinary inpatient programme | 59 adolescents completed the programme (ages 10–19); 42 returned the questionnaire | Australia | Measured three months to five years after completion of the programme | Improvement in school attendance and physical activity. Symptoms improved overall |
| Telephone-based guided self-help for adolescents with chronic fatigue syndrome: a non-randomised cohort study; Lloyd et al. (2012) | Examine the efficacy of a telephone-based guided self-help intervention for adolescents with CFS | Preliminary evidence | 63 participants (11–18 years old) | United Kingdom | Outcome measures completed at baseline, pretreatment, end of treatment and at three and six months post-treatment. Primary outcomes: Fatigue (Chalder Fatigue Scale) and School attendance. Secondary outcomes: Impairment (Social Adjustment Scale), depression (Birleson Feelings Scale), adjustment (Strengths and Difficulties Questionnaire Total Difficulties Scale), anxiety (Spence Children’s Anxiety Scale), perfectionism (Child and Adolescent Perfectionism Questionnaire) and maternal mental wellbeing (General Health Questionnaire) |
Decrease in fatigue and significant increase in school attendance |
| Chronic fatigue syndrome in children and young people; Mackenzie and Wray (2013) | Reviews the best approach to assessment, diagnosis and management of CFS/ME in children and young people | N/A | N/A | N/A | Literature review | Early diagnosis and appropriate multidisciplinary intervention aid recovery. Further research needed to improve understanding and management of condition in young people |
| Internet-based therapy for adolescents with CFS: long-term follow-up; Nijhof et al. (2013) | Assessing long-term outcome of CFS for adolescents after FITNET | FITNET trial | 112 participants (aged 12–18 years) | Netherlands | Long-term follow-up (mean 2.7 years) of FITNET. Primary outcomes: fatigue severity (Checklist Individual Strength-20), physical functioning (87-iten Child Health Questionnaire) and school/work attendance |
Short-term effectiveness of FITNET is maintained at long-term follow-up |
| Children’s experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review and meta-ethnography of qualitative studies; Parslow et al. (2017a) | Conduct a review of the qualitative studies presenting children’s experiences of CFS/ME | N/A | N/A | N/A | Systematic review and meta-ethnography | Biographical disruption; barriers and facilitators to coping; emotional aspects of recovery |
| Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services; Parslow et al. (2017b) | To understand the perspectives of pediatric CFS/ME health professionals and identify outcomes that are clinically important | N/A | 15 health professionals | United Kingdom | Qualitative; focus groups and interviews | Children with CFS/ME are impacted across multiple aspects of health |
| The course of severe chronic fatigue syndrome in childhood; Rangel et al. (2000) | Follow-up of children with CFS after diagnosis | N/A | 25 children and adolescents (12–19 years old) and parents | United Kingdom | Semi-structured interviews | Mixture of recovery and still experiencing debilitating symptoms; Factors were found to predict a quicker or more likely recovery |
| Illness beliefs in CFS: a study involving affected adolescents and their parents; Richards et al. (2006) | Investigate the beliefs of the causes and management of young people with CFS | N/A | 21 participants (each with one parent) | United Kingdom | Qualitative; open-ended interviews; content analysis | Virus infection most common cause, psychological problems as a cause was rarely reported. Resting and reducing activity managed symptoms. Positive and negative experiences of psychological treatment |
| Cortisol output in adolescents with chronic fatigue syndrome: pilot study on the comparison with healthy adolescents and change after cognitive behavioral guided self-treatment; Rimes et al. (2014) | Investigating cortisol outputs and psychological variables for adolescents with CFS after CBT | CBT through telephone-based–guided self-help | 49 adolescents with CFS and 36 healthy adolescents | United Kingdom | Saliva collection (multiple samples). Cortisol measured six months post-treatment. Multiple measures |
Daily cortisol output increased significantly after CBT |
| Cow’s milk protein intolerance in adolescents and young adults with chronic fatigue syndrome; Rowe et al. (2016) | Examine illness severity of cow milk’s protein intolerance in young people with CFS | Two-year prospective study: pre and post | 55 participants (10–23 years old) | United States | Outcome measures at baseline and six months-QOL, Multidimensional Fatigue Scale, Functional Disability Inventory | Thirty-one percentage prevalence of intolerance. Improvement after milk-free diet. Milk-sensitive participants had worse HRQOL at baseline |
| Myalgic encephalmyelitis/chronic fatigue syndrome diagnosis and management in young people: a primer; Rowe et al. (2017) | Literature review | N/A | N/A | N/A | Literature review | Overall review of literature in relation to symptoms, possible causes, prevalence and treatment strategies in pediatric population |
| Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort; Viner and Hotopf (2004) | Childhood risk factors for CFS in adults | N/A | 16,567 babies born 5–11 April 1970; followed up at 5, 10, 16 and 29–30 years old. | United Kingdom | Childhood data taken from parents and teachers. Maternal mental health examined through malaise inventory |
Higher risk of CFS/ME associated with having a chronic condition in childhood, female gender and high social status in childhood. Higher levels of exercise linked to lower risk |
| Outpatient rehabilitative treatment of chronic fatigue syndrome (CFS/ME); Viner et al. (2004) | To assess the outcome of outpatient multidisciplinary rehabilitative treatment (graded activities/exercise programme, family sessions and supportive care) compared with supportive care alone for children and adolescents with CFS/ME | Multidisciplinary programme (graded activities/exercise programme, family sessions and supportive care) | 56 young people (aged 9–17 years) with diagnosed CFS/ME | United Kingdom | After treatment, participants were followed up for 3–24 months. Primary outcome measures of Global Wellness and school attendance |
Significantly higher Wellness scores and school attendance than supportive care alone. Reduction in the overall severity of the illness |
| What stops children with a chronic illness accessing health care: a mixed methods study in children with CFS/ME; Webb et al. (2011) | Examine factors associated with amount of time it took to access specialist care | N/A | 405 children (under 18 years of age) | United Kingdom | Semi-structured interviews; thematic analysis | Inadequate time to assessment/treatment; medical practioners’ lack of knowledge; parents’ struggled with communicating CFS for child |
| A feasibility study comparing two treatment approaches for chronic fatigue syndrome in adolescents; Wright et al. (2005) | Feasibility of a larger treatment trial comparing the effectiveness of ‘Pacing’ versus ‘The STAIRway to Health’ in adolescents with CFS | Feasibility study | 13 participants (age range 8.9–16.9 years) | United Kingdom | Two treatments: ‘Pacing’ and ‘The STAIRway to Health’. Multiple outcome measures: global health; activity, school attendance, fatigue and emotional symptoms | Global health improved in both treatments. STAIRway to Health had a higher rate of improvement |
Note: CBT: cognitive behavioral therapy; CFS/ME: chronic fatigue syndrome/myalgic encephalomyelitis; RCT: randomized control trial; ALSPAC: Avon Longitudinal Study of Parents and Children; GET: graded exercise therapy; FITNET: Fatigue in Teenagers on the Internet; HRQOL: Health-related Quality of Life; QOL: quality of life.