The Severity of Chronic Fatigue among Adolescents with Congenital Heart Defects and Tentatively Healthy Schoolchildren
Worldwide, chronic fatigue is a topic of ongoing discussion. While officially recognized as a clinical diagnosis (G93.3 according to ICD-10), it still lacks clear diagnostic criteria and is considered a "diagnosis of exclusion". This article approaches chronic fatigue as a subjectively significant complaint reported by tentatively healthy schoolchildren and adolescents with congenital heart defects. This complaint significantly reduces their quality of life over time, as it hampers communication with peers and adults, lowers academic performance, and is associated with negative psychophysiological, emotional, and motivational changes. The authors analyze chronic fatigue through the lens of the biopsychosocial model. The study aimed to investigate the prevalence of chronic fatigue among relatively healthy schoolchildren and those with congenital heart defects. Participants were adolescents from 11 -17, which included 152 patients with congenital heart defects (47% girls) and 75 healthy schoolchildren (60% girls; mean age=14.7±1.7 years). Data on subjective complaints of chronic fatigue were collected using the "Chronic Fatigue Severity Scale" (Leonova, Shishkina, 2003), which assesses the overall fatigue level (Chronic Fatigue Index) and differentiates its manifestations across various life domains based on four subscales. The study found that girls in both groups reported more subjective complaints of chronic fatigue than the boys. The severity of congenital heart defects and the presence of cyanosis were not associated with the level of chronic fatigue; however, the control group reported a significantly higher level of fatigue. Significant correlations between chronic fatigue and age were not found, although opposing trends were observed in the two groups: chronic fatigue severely decreased with age in the group with congenital heart defects, while it increased in the control group. Manifestations of chronic fatigue in both groups were most pronounced in the domains of social interaction and decreased motivation. Thus, the study demonstrated that chronic fatigue is a multifactorial issue with a biopsychosocial nature, suggesting that disorders of the cardiovascular system are not the primary factor. Further research is required to clarify the contributions of individual psychosocial factors.
Keywords
chronic fatigue,
asthenic syndrome,
heart defects,
cyanosis,
schoolchildren,
adolescents,
biopsychosocial approachAuthors
| Likhomanova Elena N. | Federal Research Center for Innovator and Emerging Biomedical and Pharmaceutical Technologies | likhomanova_en@academpharm.ru |
| Shevaldova Olga V. | Federal Research Center for Innovator and Emerging Biomedical and Pharmaceutical Technologies; A.N. Bakulev Center for Cardiovascular Surgery of the Russian Ministry of Health | shevaldova_ov@academpharm.ru |
| Kovaleva Anastasia V. | Federal Research Center for Innovator and Emerging Biomedical and Pharmaceutical Technologies | kovaleva_av@academpharm.ru |
| Zavarina Anna Yu. | A.N. Bakulev Center for Cardiovascular Surgery of the Russian Ministry of Health | ayzavarina@bakulev.ru |
Всего: 4
References
Бабаева, В. А., Прибойченко, А. С., Заварина, А. Ю., Енгенова, М. С., Митченко, Е. А., Кокшина, А. В., Якубова, Л. И., Шведунова, В. Н. (2023). Особенности состояния высших психических функций у детей с врожденным пороком сердца. Детские болезни сердца и сосудов, 20(3), 191-202. doi: 10.24022/1810-0686-2023-20-3-191-202.
Горбачевский, С. В., Шмальц, А. А. (2022). Первичное обследование пациентов при легочной гипертензии, ассоциированной с врожденными пороками сердца. Детские болезни сердца и сосудов, 19(1), 25-33. doi: 10.24022/1810-0686-2022-19-1-25-33.
Леонова, А. Б., Кузнецова, А. С. (2007). Психологические технологии управления состоянием человека. М.: Смысл.
Лихоманова, Е. Н., Ковалева, А. В. (2022). Взаимосвязь выраженности синдрома хронической усталости с вегетативными и сенсомоторными функциями у детей, переживших опухоль головного мозга: обсервационное исследование. Вестник восстановительной медицины, 21(4), 60-70. doi: 10.38025/2078-1962-2022-21-4-60-70.
Чутко, Л. С., Сурушкина, С. Ю., Яковенко, Е. А., Чередниченко, Д. В. (2024). Синдром хронической усталости у детей. Журнал неврологии и психиатрии им. С.С. Корсакова, 124(9), 28-33. doi: 10.17116/jnevro202412409128.
Эльконин, Д. Б. (1997). К проблеме периодизации психического развития в детском возрасте: избранные психологические труды. М.: Ин-т практической психологии.
Collard, S. S., & Murphy, J. (2020). Management of chronic fatigue syndrome/myalgic encephalomyelitis in a pediatric population: A scoping review. Journal of Child Health Care, 24(3), 411-431. doi: 10.1177/1367493519864747.
Connelly, J. P., & O’Connell, M. (2022). Gender differences in vulnerability to maternal depression during early adolescence: Girls appear more susceptible than boys. Psychology in the Schools, 59(2), 297-315. doi: 10.1002/pits.22609.
de Vos, D. R. H., Hoefnagels, J. W., Nap-van der Vlist, M. M., Breur, J. M. P. J., & Nijhof, S. L. (2022). Prevalence of fatigue in children with congenital heart disease and correlations with disease-specific factors. Research Square. doi: 10.21203/rs.3.rs-2280678/v1.
Erol, K., Ertaş, Ş. K., & Ertaş, R. (2021). Fatigue is common and predicted by female gender and sleep disturbance in patients with chronic spontaneous urticaria. The Journal of Allergy and Clinical Immunology: In Practice, 9(1), 469-476. doi: 10.1016/j.jaip.2020.08.020.
Faro, M., Saez-Francas, N., Castro-Marrero, J., Aliste, L., Fernandez de Sevilla, T., & Alegre, J. (2016). Gender differences in chronic fatigue syndrome. Reumatología Clínica, 12(2), 72-77. doi: 10.1016/j.reuma.2015.05.007.
Grace, R. F., Klaassen, R. J., Shimano, K. A., Lambert, M. P., Grimes, A., Bussel, J. B., Breakey, V. R., Pastore, Y. D., Black, V., Overholt, K., Bhat, R., Forbes, P. W., & Neunert, C. (2020). Fatigue in children and adolescents with immune thrombocytopenia. British Journal of Haematology, 191(1), 98-106. doi: 10.1111/bjh.16751.
Lagogianni, C., Gatzonis, S., & Patrikelis, P. (2021). Fatigue and cognitive functions in epilepsy: A review of the literature. Epilepsy & Behavior, 114(Pt A), 107541. doi: 10.1016/j.yebeh.2020.107541.
Lim, E. J., Ahn, Y. C., Jang, E. S., Lee, S. W., Lee, S. H., & Son, C. G. (2020). Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Journal of Translational Medicine, 18(1), 100. doi: 10.1186/s12967-020-02269-0.
Loades, M. E., Crawley, E., Chalder, T., & Flannery, H. (2021). Paediatric chronic fatigue syndrome: 25-year perspective. Clinical Child Psychology and Psychiatry, 26(1), 8-17. doi: 10.1177/1359104520978461.
Loades, M. E., Read, R., Smith, L., Higson-Sweeney, N. T., Laffan, A., Stallard, P., Kessler, D., & Crawley, E. (2021). How common are depression and anxiety in adolescents with chronic fatigue syndrome (CFS) and how should we screen for these mental health co-morbidities? A clinical cohort study. European Child & Adolescent Psychiatry, 50(11), 1733-1743. doi: 10.1177/1359104520978461.
Ma, Y., He, B., Jiang, M., Yang, Y., Wang, C., Huang, C., & Han, L. (2020). Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. International Journal of Nursing Studies, 111, 103707. doi: 10.1016/j.ijnurstu.2020.103707.
Nacul, L., Authier, F. J., Scheibenbogen, C., Lorusso, L., Helland, I. B., Martin, J., ... Lacerda, E. M. (2021). European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): Expert consensus on the diagnosis, service provision, and care of people with ME/CFS in Europe. Medicina, 57(5), 510. doi: 10.3390/medicina57050510.
Nap-van der Vlist, M. M., Dalmeijer, G. W., Grootenhuis, M. A., van der Ent, K., van den Heuvel-Eibrink, M. M., Swart, J. F., van de Putte, E. M., & Nijhof, S. L. (2021). Fatigue among children with a chronic disease: A cross-sectional study. BMJ Paediatrics Open, 5(1), e000958. doi: 10.1136/bmjpo-2020-000958.
Ochangco, E. L. I. (2023). Early socialization of adolescent female student leaders: Gender stereotypes, leadership purpose, and role models. Asian Journal of Social Science and Legal Studies, 5(2), 42-54. doi: 10.34104/ajssls.023.042054.
Overholser, J. C., & Beale, E. E. (2019). Neurasthenia: Modern malady or historical relic? The Journal of Nervous and Mental Disease, 207(9), 731-739. doi: 10.1097/NMD.0000000000000943.
Pela, G., Goldoni, M., Solinas, E., Cavalli, C., Tagliaferri, S., Ranzieri, S., ... & Chetta, A. (2022). Sex-related differences in long-COVID-19 syndrome. Journal of Women's Health, 51(5), 620-630. doi: 10.1089/jwh.2021.0411.
Prastiwi, F., Wihastuti, T. A., & Ismail, D. D. (2021). Factors associated with fatigue in chronic kidney disease patients undergoing hemodialysis: A systematic review. Jurnal Kedokteran Brawijaya, 51(4), 260-268. doi: 10.21776/ub.jkb.2021.031.04.X.
Roman-Juan, J., Ceniza-Bordallo, G., Sanchez-Rodriguez, E., Jensen, M. P., & Miro, J. (2024). Fatigue, sleep disturbance, and pain interference in children and adolescents with chronic pain: A longitudinal study. Pain. doi: 10.1097/j.pain.0000000000003432.
Solbes-Canales, I., Valverde-Montesino, S., & Herranz-Hernandez, P. (2020). Socialization of gender stereotypes related to attributes and professions among young Spanish school-aged children. Frontiers in Psychology, 11, 609. doi: 10.3389/fpsyg.2020.00609.
Ternrud, L., Hlebowicz, J., Sandberg, C., Johansson, B., & Sparv, D. (2022). Prevalence of fatigue in adults with congenital heart disease. Cardiology in the Young, 1-8. doi: 10.1017/S1047951121004297.
Thomas, N., Gurvich, C., Huang, K., Gooley, P. R., & Armstrong, C. W. (2022). The underlying sex differences in neuroendocrine adaptations relevant to Myalgic Encephalomyelitis Chronic Fatigue Syndrome. Frontiers in Neuroendocrinology, 66, 100995. doi: 10.1016/j.yfrne.2022.100995.
Toccaceli Blasi, M., Alfano, A. R., & Salzillo, M. (2024). Sex-specific clinical and neurobiological correlates of fatigue in older adults. GeroScience. doi: 10.1007/s11357-024-01259-0.
Vasenina, E. E., Gankina, O. A., & Levin, O. S. (2022). Stress, asthenia, and cognitive disorders. Neuroscience and Behavioral Physiology, 52(9), 1341-1347. doi: 10.1007/s11055-023-01364-1.
Verheyen, V. J., Remy, S., Govarts, E., Colles, A., Koppen, G., Martin, L. R., ... Schoeters, G. (2021). Determinants of chronic biological stress, measured as hair cortisol concentration, in a general population of adolescents: From individual and household characteristics to neighborhood urbanicity. Frontiers in Public Health, 9, 669022. doi: 10.3389/fpubh.2021.669022.
