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Comparative Study of Anxiety, Depression, Somatization,
Functional Disability, and Illness Attribution in
Adolescents with Chronic Fatigue or Migraine
Smith MS, Martin-Herz SP, Womack WM, Marsigan JL.
Posted: September 2004  
Pediatrics 2003;111:376-381

Objective:   To compare adolescents with migraine, unexplained profound chronic fatigue of >6 months duration, and normal school controls on measures of anxiety, depression, somatization, functional disability, and illness attribution.

Methods:   Adolescents referred to Children’s Hospital and Regional Medical Center for behavioral treatment of migraine or evaluation of chronic fatigue were compared with a group of healthy controls of similar age and sex from a middle school. Migraine and fatigued subjects completed an illness attribution questionnaire.

Conclusions:   Adolescents referred to an academic center for evaluation of unexplained chronic fatigue had greater rates of school absenteeism than adolescents with migraine or healthy controls. Those meeting Centers for Disease Control and Prevention criteria for chronic fatigue syndrome had higher anxiety scores than controls and higher depression and somatization scores than migraineurs or controls. Parents of adolescents with idiopathic chronic fatigue syndrome were less likely to endorse psychological factors as possibly contributing to their symptoms than parents of adolescents with Centers for Disease Control and Prevention criteria for chronic fatigue syndrome or migraine.