Fowler, Tom, Duthie, Pamela, Thapar, Anita et al. · BMC family practice · 2005 · DOI
This study looked at how disabling fatigue in children and teens should be defined, since the current definition used for adults might not fit young people well. Researchers found that children with disabling fatigue that didn't quite meet the strict adult criteria still suffered just as much and missed just as much school as those who did meet the strict criteria. The study suggests that doctors should use a broader, less restrictive definition to catch all children who need help.
This study challenges whether adult-based diagnostic criteria adequately identify children with ME/CFS who are severely affected, showing that many children with disabling fatigue fall outside narrow diagnostic definitions yet experience equivalent impairment. Better case definitions in pediatric populations could improve access to diagnosis and support for affected children and families.
This study does not prove that broader definitions are superior to narrow definitions; it only shows that impairment is similar between groups. It cannot establish causation or biological mechanisms underlying disabling fatigue in children. The cross-sectional design provides no information about outcomes or how definitions affect treatment response.
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
Fowler, Tom, Duthie, Pamela, Thapar, Anita, & Farmer, Anne (2005). The definition of disabling fatigue in children and adolescents.. BMC family practice. https://doi.org/10.1186/1471-2296-6-33
BibTeX
@article{mecfsatlas-fowler-2005-definition-disabling,
author = {Fowler, Tom and Duthie, Pamela and Thapar, Anita and Farmer, Anne},
title = {The definition of disabling fatigue in children and adolescents.},
journal = {BMC family practice},
year = {2005},
doi = {10.1186/1471-2296-6-33},
note = {PubMed: 16091130},
url = {https://www.mecfsatlas.com/evidence/fowler-2005-definition-disabling},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/fowler-2005-definition-disabling
Contribute
Private, reviewed by a human. Not a public comment thread.