One in five adolescent girls may suffer from severe fatigue, according to a new survey.

“It is very intriguing that we found such a high percentage of adolescents who scored above the clinical cutoff score in a so-called ‘healthy’ population,” Dr. Maike ter Wolbeek of the University Medical Center Utrecht in the Netherlands and her colleagues write. Future research, they add, should investigate whether fatigue in the teen years increases the risk of illness in later life, including chronic fatigue syndrome (CFS).

Fatigue is a common problem for teens, “and is often attributed to hormonal changes during puberty, psychological struggles, and new educational and social demands,” Wolbeek and her team note in the medical journal Pediatrics. To investigate how common fatigue is in healthy teens, and determine its relationship to other symptoms, Wolbeek and her team surveyed 3,454 healthy adolescent boys and girls.

Among girls, 20.5 percent had symptoms of severe fatigue, and 80 percent of these subjects had been fatigued for a month or more. Nearly half of the girls reporting severe fatigue had suffered symptoms for three months or longer.

Just 6.5 percent of boys reported having severe fatigue, with 61.5 percent of this group having the symptoms for a month or longer, while just over a third had been fatigued for three months or more.

The researchers found a relationship between symptoms of depression and anxiety and fatigue in both boys and girls. Girls overall were more likely than boys to report depression, anxiety and CFS symptoms such as unrefreshing sleep, difficulty concentrating, muscle and joint pain and headaches. Lower participation in sports was associated with greater fatigue in both sexes, while not having an additional job increased the likelihood of fatigue in girls.

Older girls, as well as those who had begun menstruating earlier, were more likely to be fatigued. Medication use also was tied to fatigue for females. The longer a person had suffered from fatigue, the more severe the symptoms.

In girls, sleeping longer on the weekends was associated with fatigue, while boys who slept less on school nights were more likely to be fatigued. “Overall, however, the contribution of sleep characteristics to fatigue was smaller than we expected,” the researchers write.

“Our data warrant a follow-up study to investigate whether severe fatigue during adolescence, which is considered to be a crucial period of life, is a predictor for the development of fatigue-related illnesses or other diseases in later life,” they conclude.

SOURCE: Pediatrics, June 2006.