New paper by Dr Crawley about CFS/ME (?) in children

[Countrygirl]

http://adc.bmj.com/content/early/2013/10/21/archdischild-2012-302156.short

Arch Dis Child doi:10.1136/archdischild-2012-302156

• Review

The epidemiology of chronic fatigue syndrome/myalgic encephalitis in children

1. Esther Crawley​

1. Correspondence toDr Esther Crawley, University of Bristol, Centre for Child and Adolescent Health, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; esther.crawley@bristol.ac.uk

• Received 2 September 2013
• Accepted 2 October 2013
• Published Online First 21 October 2013

Abstract

Most paediatricians regularly see children with chronic fatigue syndrome or myalgic encephalitis (!) (CFS/ME) in their clinics and yet we know little about how common it is, who is affected, whether there are risk factors and how likely a child is to recover (or what might predict recovery). Recent research suggests that this illness is more complicated than previously thought and that rather than being an illness found in middle class families, it is more common in those who are socially deprived. This article reviews what is currently known about this important but little understood condition.


It sounds as if Dr Crawley has discovered that a spot of LP doesn't work.

What ............er..........is Myalgic Encephalitis?? I've never heard of it. As an acknowledged national expert in a condition, shouldn't you at least know the correct name?

(Okay, I guess it was just a typo......but who could resist in the circumstances??)

Has anyone full access to this paper, please?

 

[Firestormm]

I have come across this term 'myalgic encephalitis' in various things that have crossed by inbox. I don't think it is a commonly used term, but it is used.

Must admit though that each time I see it I do pause to ask if they have made a mistake, and I don't know where it comes from.

Google Search:



Esther should know better.

Yes I wouldn't mind a read of the full paper either. I do wish the BMJ of all people would remove their damned subscription policy and allow free access.

 

[Countrygirl]

Fire ...................* waving to you from over the Tamar.................here is a quote to whet your appetite. I will resist all comment.

Exercise
It is not known whether exercise is a risk factor or protective
for CFS/ME with conflicting evidence in adults.29–31 Reduced
physical activity may be associated with new onset of fatigue
12 months later32 and with extreme tiredness occurring more
than once a week in adolescents12 but the effect on CFS/ME is
not known. Both excessive exercise and sedentary behaviour are
plausible risk factors and further investigation is required to
understand the complex nature of exercise and fatigue.
Anxiety and depression
Both anxiety and low mood are more common in children with
CFS/ME than either healthy controls or children with other
chronic illnesses.33–36 Teenage girls are those most likely to have
a problem with anxiety, with up to 38% of those attending a
specialist service scoring above the 10% upper cut-off level.37
Depression is also common, with 29% of children with CFS/
ME having probable depression.38 These results are consistent
with population studies that describe an association between
anxiety and CFS/ME.14 It is not known whether the associated
mood disorders contribute to the development of CFS/ME or
are caused by it.39 There are currently no longitudinal studies
that are sufficiently powered to investigate this, although several
describe an association between mood disorders and later onset
of fatigue.8 12 32


Socio-economic factors and family adversity
CFS/ME used to be called ‘yuppie flu’; however, the epidemiology
suggests the reverse is true and that CFS/ME is more
common in those experiencing social deprivation. In the adult
literature, an association with those from higher socioeconomic
classes is only described for those who have successfully
obtained a CFS/ME label.30 However, this could be explained
by successful health-seeking behaviour. Studies that screen for
CFS/ME report no association with social class or an association
with lower social economic class.40 41 This suggests that CFS/
ME is more common in those from lower socioeconomic backgrounds
but is more likely to be diagnosed in wealthier families.
In children, family adversity in pregnancy has been shown to
be associated with CFS/ME in 13 year olds.13 In this study,
family adversity was measured using a family adversity index
derived from responses to questions about early childhood
adversity (eg, partner aggression, substance abuse) and socioeconomic
status (eg, housing adequacy, basic home amenities)
completed during pregnancy (see13 for more details). This study
showed an approximately linear increase in the log odds of
developing chronic disabling fatigue lasting 3 months and 6 months with increasing numbers of family adversity factors so
that families with 4 factors were 2.6 times more likely to
develop CFS/ME compared with families with no family adversity
factors (OR of 2.56 (95% CI 1.01 to 6.45)). There are
several possible explanations for this finding:
A. Family adversity could have an epigenetic effect on the
developing fetus. In other words, the experience of family
adversity during pregnancy could change gene expression in
developing fetuses such that they were at higher risk of
developing CFS/ME as a teenager.
B. Family adversity in pregnancy is likely to be associated with
family adversity 10 years later, which may affect susceptibility
to CFS/ME. This would be consistent with adult studies
showing an association between socioeconomic status and
CFS/ME in cross-sectional studies.
C. Family adversity in pregnancy may be associated with
adverse events between ages 6–8 years, which are associated
with higher levels of proinflammatory cytokines at age
10 years.42
D. The factor providing the strongest association with CFS/ME
at 13 years was maternal psychopathology (high levels of
depression, anxiety or attempted suicide) in pregnancy.
Maternal psychopathology may have an epigenetic effect in
pregnancy or be associated with maternal psychopathology
at 13 or prior to the development of CFS/ME.
Child abuse
Retrospective case-control studies have suggested an association
between childhood trauma (physical, emotional and sexual
abuse, or physical or emotional neglect) and CFS/ME in adults.
These studies suggest that the association could be mediated
through neuroendocrine dysfunction because only those with
CFS/ME and a history of abuse had decreased mean early
morning cortisol levels.43 44 However, this work needs to be
replicated in a population cohort as retrospective studies may be
biased and it is not clear whether the results will be relevant for
CFS/ME in children as well as adults.
Maternal risk factors
Mothers of children with CFS/ME have higher rates of psychological
distress compared with the general population.45 46
However, as these are cross-sectional studies it is not possible to
know whether this is primary or secondary to having a child
with a chronic disabling condition.

 

[Snow Leopard]

Recent research suggests that this illness is more complicated than previously thought

I wonder who was doing the thinking?

 

[meandthecat]

why don't they add alien abduction to the list or maybe walking on the cracks between paving stones. Why does science seem to give people the platform to spout garbage with authority,

I have no problem with science merely with stupid people,