Three ME/CFS Severities and Types Found in Children & Teens

I am always looking for information on ME/CFS in children and teenagers and there isn’t much out there so when I saw this study from ProHealth, I wanted to include it.   Since I am not a doctor or a medical professional of any kind, I don’t want to misinterpret the study information below so I am going to post it verbatim and I have included the source link so that nothing is taken out of context.  If you have any questions regarding this information, please refer to the source link. 

Objective: To investigate the heterogeneity of chronic fatigue syndrome (CFS/ME) in children and young people.

Setting: Regional specialist CFS/ME service.

Patients: Children and young people aged under 19 years old.

Methods: Exploratory factor analysis was performed on symptoms present at assessment in 333 children and young people with CFS/ME.

Linear and logistic regression analysis of data from self completed assessment forms was used to explore the associations between the retained factors and sex, age, length of illness, depression, anxiety and markers of severity (fatigue, physical function, pain and school attendance).

Three phenotypes were identified using factor analysis:

Musculoskeletal (Factor 1) had loadings on muscle and joint pain and hypersensitivity to touch, and was associated with worse
– Fatigue (regression coefficient 0.47, 95% CI 0.25, 0.68, p <0.001),
– Physical function (regression coefficient -0.52, 95% CI -0.83, -0.22, p=0.001)
– And pain.

Factor 2 (Migraine) loaded on noise and light hypersensitivity, headaches, nausea, abdominal pain and dizziness and was most strongly associated with physical function and pain.

Sore throat phenotype (Factor 3) had loadings on sore throat and tender lymph nodes and was not associated with fatigue or pain.

There was no evidence that phenotypes were associated with age, length of illness, or symptoms of depression (regression coefficient for association of depression with Musculoskeletal pain -0.02, 95% CI -0.27, 0.23, p= 0.87).

The Migraine phenotype was associated with anxiety (0.40, 95% CI 0.06, 0.74, p=0.02).

Implications: CFS/ME is heterogeneous in children with 3 phenotypes at presentation that:

• Are differentially associated with severity

• And are unlikely to be due to age or length of illness.

Source: Archives of Disease in Childhood, online Oct 19, 2009; print Apr 2010. PMID: 19843509, by May M, Emond A, Crawley E. Bristol University, UK. [E-mail:]


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  1. I treated a 17 year old with ME/CFS earlier this year with Mickel Therapy. She presented with Factor One type symptoms and had done on and off since aged 13. She was having problems attending college and keeping up with studying due to her illness. With Mickel Therapy she learnt how to put her own needs before those of others, how to use her emotions constructively and how to lead a more fulfilling life. She learnt this over 6 one hour sessions and by the time she sat her A levels she was completely recovered and leading a perfectly normal teenage life.

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