Pinquart, Martin, Thorwarth, Alexander · Journal of pediatric psychology · 2025 · DOI
This study looked at whether children and teenagers with chronic physical illnesses experience more anxiety than their healthy peers. By reviewing over 1,250 research papers, scientists found that young people with long-term health conditions do tend to have higher anxiety levels. Children with chronic fatigue syndrome showed notably elevated anxiety compared to other chronic conditions studied.
This meta-analysis provides robust evidence that anxiety is a significant concern in youth with chronic conditions, including ME/CFS, with effect sizes (g=0.54) comparable to or exceeding other well-recognized chronic illnesses. For ME/CFS patients and families, this validates the psychological burden of the condition in young people and supports the clinical need for routine anxiety screening and intervention in pediatric ME/CFS care. The findings underscore that psychological health management should be integrated into comprehensive treatment approaches for young people with ME/CFS.
This meta-analysis does not establish causality—anxiety could precede the illness, result from it, or both could share common biological mechanisms. The study does not examine whether anxiety arises specifically from symptom burden, social isolation, diagnostic uncertainty, or other disease-related factors in ME/CFS. Effect sizes, while elevated, remain modest overall (g=0.31), and the study does not clarify what proportion of youth with chronic conditions meet clinical anxiety disorder thresholds versus experiencing subclinical 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 →
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