چکیده (انگلیسی):

Background:Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a complex condition. Causal factors
are not established, although underlying psychological or immunological susceptibility has been proposed. We
studied primary care diagnoses for children with CFS/ME, with children with another hospital diagnosis (type 1
diabetes mellitus [T1DM]) and the general child population as comparison groups.
Methods:All Norwegian children born 1992–2012 constituted the study sample. Children with CFS/ME (n= 1670)
or T1DM (n= 4937) were identified in the Norwegian Patient Register (NPR) (2008-2014). Children without either
diagnosis constituted the general child population comparison group (n= 1337508). We obtained information on
primary care diagnoses from the Norwegian Directorate of Health. For each primary care diagnosis, the proportion
and 99 % confidence interval (CI) within the three groups was calculated, adjusted for sex and age by direct
standardization.
Results:Children with CFS/ME were more often registered with a primary care diagnosis of weakness/general
tiredness (89.9 % [99 % CI 88.0 to 91.8 %]) than children in either comparison group (T1DM: 14.5 % [99 % CI: 13.1
to 16.0 %], general child population: 11.1 % [99 % CI: 11.0 to 11.2 %]). Also, depressive disorder and anxiety disorder
were more common in the CFS/ME group, as were migraine, muscle pain, and infections. In the 2 year period prior
to the diagnoses, infectious mononucleosis was registered for 11.1 % (99 % CI 9.1 to 13.1 %) of children with CFS/
ME and for 0.5 % (99 % CI (0.2 to 0.8 %) of children with T1DM. Of children with CFS/ME, 74.6 % (1292/1670) were
registered with a prior primary care diagnosis of weakness / general tiredness. The time span from the first primary
care diagnosis of weakness / general tiredness to the specialist health care diagnosis of CFS/ME was 1 year or
longer for 47.8 %.
Conclusions:This large nationwide registry linkage study confirms that the clinical picture in CFS/ME is complex.
Children with CFS/ME were frequently diagnosed with infections, supporting the hypothesis that infections may be
involved in the causal pathway. The long time span often observed from the first diagnosis of weakness / general
tiredness to the diagnosis of CFS/ME might indicate that the treatment of these patients is sometimes not optimal.