Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2074-2079 (doi:10.1542/peds.2005-2307)
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Mirrored Symptoms in Mother and Child With Chronic Fatigue Syndrome

Elise M. van de Putte, MDa, Lorenz J. P. van Doornen, PhDb, Raoul H. H. Engelbert, PhD, PTc, Wietse Kuisa, Jan L. L. Kimpen, PhD, MDa and Cuno S. P. M. Uiterwaal, PhD, MDd

a Departments of Pediatrics
c Pediatric Physical Therapy and Pediatric Exercise Physiology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, Netherlands
b Department of Health Psychology, University Utrecht, Utrecht, Netherlands
d Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands

OBJECTIVE. Our aim with this study was to assess the relation between chronic fatigue syndrome in adolescents and fatigue and associated symptoms in their fathers and mothers, more specifically the presence of chronic fatigue syndrome-like symptoms and psychologic distress.

METHOD. In this cross-sectional study, 40 adolescents with chronic fatigue syndrome according to the Centers for Disease Control and Prevention criteria were compared with 36 healthy control subjects and their respective parents. Questionnaires regarding fatigue (Checklist Individual Strength), fatigue-associated symptoms, and psychopathology (Symptom Checklist-90) were applied to the children and their parents.

RESULTS. Psychologic distress in the mother corresponds with an adjusted odds ratio of 5.6 for the presence of CFS in the child. The presence of fatigue in the mother and dimensional assessment of fatigue with the Checklist Individual Strength revealed odds ratios of, respectively, 5.29 and 2.86 for the presence of chronic fatigue syndrome in the child. An increase of 1 SD of the hours spent by the working mother outside the home reduced the risk for chronic fatigue syndrome in their child with 61%. The fathers did not show any risk indicator for chronic fatigue syndrome in their child.

CONCLUSIONS. Mothers of adolescents with chronic fatigue syndrome exhibit fatigue and psychologic symptoms similar to their child in contrast with the fathers. The striking difference between the absent association in fathers and the evident association in mothers suggests that the shared symptom complex of mother and child is the result of an interplay between genetic vulnerability and environmental factors.

Key Words: chronic fatigue syndrome • familial aggregation • family health • risk • psychopathology

Abbreviations: CFS—chronic fatigue syndrome • CDC—Centers for Disease Control and Prevention • CIS-20—Checklist Individual Strength • SCL-90-R—revised Symptom Checklist • CDI—Children’s Depression Inventory • OR—odds ratio • 95% CI—95% confidence interval

Accepted Nov 22, 2005.




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