Article Text
Abstract
Objectives At least 30% of young people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) also have symptoms of depression. This systematic review aimed to establish which treatment approaches for depression are effective and whether comorbid depression mediates outcome.
Setting A systematic review was undertaken. The search terms were entered into MEDLINE, EMBASE, PsycInfo and the Cochrane library.
Participants Inclusion and exclusion criteria were applied to identify relevant papers. Inclusion criteria were children age <18, with CFS/ME, defined using CDC, NICE or Oxford criteria, and having completed a valid assessment for depression.
Results 9 studies were identified which met the inclusion criteria, but none specifically tested treatments for paediatric CFS/ME with depression and none stratified outcome for those who were depressed compared with those who were not depressed. There is no consistent treatment approach for children with CFS/ME and comorbid depression, although cognitive–behavioural therapy for CFS/ME and a multicomponent inpatient programme for CFS/ME have shown some promise in reducing depressive symptoms. An antiviral medication in a small scale, retrospective, uncontrolled study suggested possible benefit.
Conclusions It is not possible to determine what treatment approaches are effective for depression in paediatric CFS/ME, nor to determine the impact of depression on the outcome of CFS/ME treatment. Young people with significant depression tend to have been excluded from previous treatment studies.
- chronic fatigue syndrome
- CFS/ME
- paediatric
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Footnotes
Contributors MEL and EC conceptualised and designed the study. MEL and EAS carried out the data search and analysis. MEL drafted the manuscript. EC contributed to the analysis process by when there was uncertainty about decisions about whether studies met the inclusion criteria. EC reviewed and revised the manuscript. All authors reviewed and approved the manuscript prior to submission.
Funding This study was funded by donated Funds from the Royal National Hospital for Rheumatic Diseases (RNHRD) grant number RNP00267331143E. EC is funded by the NIHR (Senior Research Fellowship, SRF-2013-06-013).
Disclaimer This report is independent research. The views expressed in this publication are those of the authors(s) and not necessarily those of the NHS, The National Institute for Health Research or the Department of Health.
Competing interests EC is an unpaid medical advisor to the Association for young people with ME and the Sussex & Kent ME/CFS Society.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement This systematic review draws on published research only. No new data were collected or generated in undertaking this study.
