Who should we ask about mental health symptoms in adolescents with CFS/ME? Parent-child agreement on the revised children's anxiety and depression scale. — CFSMEATLAS
Who should we ask about mental health symptoms in adolescents with CFS/ME? Parent-child agreement on the revised children's anxiety and depression scale.
Serafimova, Teona, Loades, Maria, Gaunt, Daisy et al. · Clinical child psychology and psychiatry · 2021 · DOI
Quick Summary
This study looked at how well parents and teenagers with ME/CFS agreed when reporting on anxiety and depression symptoms. Researchers compared what 93 teenagers said about their mental health with what their parents said, using a standard questionnaire. Both teenagers and parents were reasonably accurate at spotting mental health problems, though teenagers more often reported reaching diagnostic thresholds. The findings suggest that doctors should listen to both the young person and their parent, since severe fatigue might make it harder for teenagers to fully report their symptoms on their own.
Why It Matters
Mental health problems affect approximately one in three adolescents with ME/CFS, yet diagnosis can be challenging because severe fatigue may interfere with self-reporting. This study clarifies that clinicians need input from both young people and parents to accurately assess anxiety and depression, helping improve psychological care in this population. The findings validate using multi-informant approaches when evaluating mental health in ME/CFS rather than relying solely on either source.
Observed Findings
Adolescents met diagnostic thresholds on RCADS more frequently than parents reported.
Both child-report and parent-report showed similar sensitivity and specificity compared to gold-standard diagnostic interviews.
Odds ratios for detecting anxiety were comparable between child-report (OR=1.10) and parent-report (OR=1.10).
Odds ratios for depression detection were similar between child-report (OR=1.26) and parent-report (OR=1.25).
Reasonable agreement was observed overall between parent and child reports on total mental health symptom scores.
Inferred Conclusions
Parent-report of mental health symptoms can facilitate psychological assessment in adolescents with CFS/ME, particularly useful when severe fatigue limits children's ability to complete self-report measures.
Child-report remains essential and should not be replaced by parent-report alone, as they provide complementary but not identical perspectives.
A multi-informant assessment approach is appropriate for accurate psychological evaluation in pediatric CFS/ME.
Remaining Questions
Which specific mental health symptoms or symptom clusters show the greatest parent-child disagreement in CFS/ME?
How does the severity of fatigue or physical symptom burden affect the reliability of each informant's report?
What This Study Does Not Prove
This study does not establish whether anxiety or depression cause or result from ME/CFS, nor does it determine optimal treatment approaches for mental health in this population. The study also does not identify which specific symptoms parents and children most disagree about, limiting practical guidance on which symptoms warrant particular scrutiny from clinicians.
Tags
Symptom:Fatigue
Phenotype:Pediatric
Method Flag:Weak Case DefinitionNo ControlsSmall Sample