The role of psychiatry in diagnosis and treatment of paediatric chronic fatigue syndrome - a scoping literature review.
Dolp, Reinhard, Wardle, David Pr, Khalid-Khan, Sarosh · International journal of adolescent medicine and health · 2023 · DOI
Quick Summary
This review looked at how psychiatry (the medical specialty focused on mental health) is involved in diagnosing and treating ME/CFS in children and teenagers. The researchers searched medical literature and found that psychiatrists are rarely part of the care team for young people with ME/CFS, and when they are involved, their role is often unclear or limited to treating separate mental health problems. The study suggests that psychiatry could potentially play a more defined and helpful role in caring for children and adolescents with ME/CFS.
Why It Matters
This review highlights a significant gap in pediatric ME/CFS care: psychiatrists are underutilized despite the disease's substantial impact on psychological development and mental health. Understanding how psychiatry could better contribute to diagnosis and treatment may improve overall care quality and reduce the risk of misdiagnosis or inadequate support for young patients.
Observed Findings
- Of 436 articles reviewed, only 16 met inclusion criteria for psychiatric involvement in pediatric CFS diagnosis or treatment
- Most published studies and clinical guidelines did not include any psychiatric involvement in pCFS care
- When psychiatry was mentioned, it was used interchangeably with psychological interventions or limited to managing distinct psychiatric comorbidities and suicidal ideation
- 12 additional clinical guidelines from grey literature search were identified, yet showed similar patterns of minimal psychiatric integration
Inferred Conclusions
- The role of psychiatry in pediatric CFS diagnosis and treatment is poorly defined in current literature and clinical guidelines
- Psychiatrists are rarely engaged as part of the multidisciplinary care team for children and adolescents with CFS
- Future research and clarification are needed to establish appropriate psychiatrist involvement in pediatric CFS management
Remaining Questions
- What specific psychiatric competencies or interventions could benefit children and adolescents with ME/CFS?
- How should psychiatrists differentiate between psychiatric symptoms that are primary features of ME/CFS versus true comorbid psychiatric disorders in pediatric patients?
What This Study Does Not Prove
This scoping review does not establish whether psychiatric involvement would improve patient outcomes, nor does it determine whether psychiatric symptoms in ME/CFS are primarily causal, consequential, or comorbid. The study identifies an organizational gap in clinical practice but does not prove that expanded psychiatric involvement would be beneficial.