Symptoms of Chronic Fatigue Syndrome/Myalgic Encephalopathy (CFS/ME) include:

• Debilitating Fatigue
• Cognitive Difficulties
• Widespread Pain
• PostExertional Malaise
• Sore Throat
• Irritable Bowel Syndrome (IBS)
• Sleep Disorders

In adults with CFS/ME, these symptoms usually all occur at the same time at the onset of the illness. Children are often misdiagnosed because their symptoms will migrate. Due to the cognitive difficulties seen in this illness (short-term memory problems, lack of concentration), CFS children can be misdiagnosed and told they have attention deficit disorder (ADD).

Children with CFS/ME can appear normal and appear as though their activity levels are normal but upon closer evaluation, the parent will find that their child has to rest more after a sporting event, dance or other physical activity. Many people believe they had a milder case of CFS/ME as a child that exasperated when they got older. Many doctors attribute pain in children to "growing pains" when indeed they most likely had CFS/ME.

Pediatric patients with CFS/ME are less likely to have severe mood-related symptoms compared with patients who are suffering from clinical depression (eg, major depression). These mood-related symptoms include negative affect, suicidal ideation or previous suicidal behavior, externalizing or acting-out behaviors, problems with angry or aggressive behavior, low self-esteem, and feelings of reduced self-efficacy. Thus, research findings with pediatric patients suggest that children and adolescents with CFS/ME are not depressed in the conventional sense. Nevertheless, these patients are psychologically distressed when compared with healthy people of the same age.

Although social and academic activities may be disrupted, children with CFS/ME do not demonstrate the same level of decline in these areas experienced by children with clinical depression. Many children with CFS/ME are high achievers and report dissatisfaction even with above-average performance. Self-esteem and self-concept concerns are less likely to be issues than with depressed youth. Anecdotally, numerous investigators and clinicians have noted that pediatric patients with CFS/ME and their family members are inclined to deny the need for psychological assistance for their personal problems, to minimize the role of stressors in their symptoms, and to reject suggestions that psychological assistance may facilitate their recovery. They generally attribute their symptoms to infectious and immunological causes, which may be strongly reinforced by the lay literature.

Clearly, a disease this debilitating affects multiple aspects of functioning and development, as well as the life of the family as a whole. Many subjects reported regression via increased dependence in their relationship with their parents because of their physical limitations. The patients spent more time with their parents than the average adolescent or young adult and believed their health status made their parents overprotective and more cautious. At a time when many healthy peers are gaining more freedom and independence from their parents, these families displayed a level of involvement that may have delayed some of these common rites of passage, such as moving out of the home, going away to college, and working full-time.

In terms of their school functioning, many subjects in the study reported cutting back on the hours and days that they spent in class, despite previous successes achieved in the academic arena. Curiously, although many subjects believed that their grades had declined, they still believed that they performed at a level either commensurate with or superior to their classmates. Subjects reported a preference for quieter activities with smaller groups of friends and indicated that they received criticism and disbelief from some peers and teachers regarding the validity of their illness and lengthy absences.