Crawley, Esther, Hunt, Linda, Stallard, Paul · European child & adolescent psychiatry · 2009 · DOI
This study looked at anxiety in children with ME/CFS and found that anxiety is common, especially in teenage girls. Researchers compared anxiety levels in 164 children with ME/CFS to healthy European children and found that 38% of teenage girls with ME/CFS had unusually high anxiety symptoms. Interestingly, anxiety levels did not seem to be connected to how much school the children attended or how severe their physical symptoms were.
Understanding the types and prevalence of anxiety in children with ME/CFS is crucial for appropriate clinical assessment and treatment. This study challenges the assumption that anxiety drives school absence or disability in pediatric ME/CFS, suggesting that anxiety and functional limitation may be independent features of the illness that require separate clinical attention.
This study does not establish causation between anxiety and ME/CFS symptoms; it only documents that they co-occur. The cross-sectional design cannot determine whether anxiety develops as a response to having ME/CFS, is a primary feature of the condition, or represents a separate comorbidity. The study also does not examine treatment response or whether addressing anxiety improves other ME/CFS symptoms.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Crawley, Esther, Hunt, Linda, & Stallard, Paul (2009). Anxiety in children with CFS/ME.. European child & adolescent psychiatry. https://doi.org/10.1007/s00787-009-0029-4
BibTeX
@article{mecfsatlas-crawley-2009-anxiety-children,
author = {Crawley, Esther and Hunt, Linda and Stallard, Paul},
title = {Anxiety in children with CFS/ME.},
journal = {European child & adolescent psychiatry},
year = {2009},
doi = {10.1007/s00787-009-0029-4},
note = {PubMed: 19452195},
url = {https://www.mecfsatlas.com/evidence/crawley-2009-anxiety-children},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/crawley-2009-anxiety-children
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