{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:23:48Z","timestamp":1790907828291,"version":"4.1.0"},"reference-count":50,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,4,1]]},"abstract":"<jats:p>Objective. To compare adolescents with migraine, unexplained profound chronic fatigue of &amp;gt;6 months duration, and normal school controls on measures of anxiety, depression, somatization, functional disability, and illness attribution.<\/jats:p><jats:p>Methods. Adolescents referred to Children\u2019s Hospital and Regional Medical Center for behavioral treatment of migraine (n = 179) or evaluation of chronic fatigue (n = 97) were compared with a group of healthy controls of similar age and sex from a middle school (n = 32). Subjects completed the Spielberger State-Trait Anxiety Inventory-Trait Form, the Children\u2019s Depression Inventory, the Childhood Somatization Inventory, and estimated the number of school days missed in the past 6 months because of illness. Migraine and fatigued subjects completed an illness attribution questionnaire.<\/jats:p><jats:p>Results. Subjects in the 3 groups were 56% to 70% female and ranged from 11 years old to 18 years old with a mean age of 14.0 \u00b1 2.0. Forty-six of the 97 chronically fatigued adolescents met 1994 Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome (CDC-CFS), while 51 had idiopathic chronic fatigue syndrome (I-CFS) that did not meet full CDC criteria. Adolescents with migraine had significantly higher anxiety scores than those with I-CFS or controls and higher somatization scores than controls. Adolescents with CDC-CFS had significantly higher anxiety scores than those with I-CFS or controls, and higher depression and somatization scores than all other groups. There were significant differences between all groups for school days missed with CDC-CFS more than I-CFS more than migraine more than controls. Parents of adolescents with unexplained I-CFS had significantly lower attribution scores relating illness to possible psychological or stress factors than parents of adolescents with CDC-CFS or migraine.<\/jats:p><jats:p>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 CDC-CFS criteria had higher anxiety scores than controls and higher depression and somatization scores than migraineurs or controls. Parents of adolescents with I-CFS were less likely to endorse psychological factors as possibly contributing to their symptoms than parents of adolescents with CDC-CFS or migraine.<\/jats:p>","DOI":"10.1542\/peds.111.4.e376","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"e376-e381","source":"Crossref","is-referenced-by-count":92,"title":["Comparative Study of Anxiety, Depression, Somatization, Functional Disability, and Illness Attribution in Adolescents With Chronic Fatigue or Migraine"],"prefix":"10.1542","volume":"111","author":[{"given":"Mark S.","family":"Smith","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital & Regional Medical Center, Department of Pediatrics, University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne P.","family":"Martin-Herz","sequence":"additional","affiliation":[{"name":"Departments of Psychology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Womack","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L.","family":"Marsigan","sequence":"additional","affiliation":[{"name":"Departments of Psychology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,4,1]]},"reference":[{"key":"2021121003270226800_R1","doi-asserted-by":"crossref","unstructured":"Marshall GS. 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