Severe chronic fatigue syndrome in chidhood: A discussion of psychopathological mechanisms.

Severe chronic fatigue syndromes are rare in childhood. Two severely affected children are described, one presenting in an extreme withdrawal state. Possible psychopathological mechanism are discussed including the relevance of viral illnesses, depressive symptoms, characteristic child personality and family relationship. These mechanisms are comparable to those described for other functional somatic problems of childhood, suggesting their general relevance in the maintenance of the somatization of distress in childhood. Treatment strategies are described which resulted in recovery in both cases.