Independent: What’s wrong with you? It depends where you live (Wessely)

Update: Letter below was published in the print edition on 30 April.

The ME Association has made the following response which includes this description of “Pacing” – a description which sounds more like GET (Graded Exercise Therapy) or APT (Adaptive Pacing Therapy) to me:

“The key to recovery in ME/CFS is careful pacing of activities – a process involving small but flexible increases in activity that take account of the person’s limitations.”
 

http://www.meassociation.org.uk/content/view/852/161/

ME Association responds to The Independent

The ME Association has responded to an article by Jeremy Laurence in which he interviewed Professor Simon Wessely, which appeared yesterday (Monday, April 27) on the health pages of The Independent newspaper.

INTENDED FOR PUBLICATION

RE: WHAT’S WRONG WITH YOU? IT DEPENDS ON WHERE YOU LIVE

Sir

Whilst agreeing that many French doctors still refuse to accept that ME/CFS exists as a distinct clinical entity, this situation cannot be used to conclude that the illness is not present in France.

A proper epidemiological study (1), which investigated the prevalence of persistent fatigue in France, found that this is a significant and common presenting complaint in primary care. Here at The ME Association we are regularly contacted by people in France who are desperately seeking help with regard to both diagnosis and management – some of whom appear to be receiving inaccurate explanations for their persisting ill health.

The simple fact is that if people with ME/CFS do too much and exceed their limitations – as may be advised by doctors who believe the problem lies in abnormal illness beliefs and behaviour. – they invariably feel worse as a result. The key to recovery in ME/CFS is careful pacing of activities – a process involving small but flexible increases in activity that take account of the person’s limitations. All of which is consistent with the neurological abnormalities that has led the World Health Organisation to officially classify ME as a neurological disorder (in section G93.3 in ICD10)..

Dr Charles Shepherd
Hon Medical Adviser, ME Association

7 Apollo Office Court
Radclive Road
Gawcott
Buckinghamshire MK18 4DF

Web: www.meassociation.org.uk

Reference

The epidemiology of fatigue and depression: A French primary care study. Psychological Medicine. 25 (5) 895 – 906, September 1995.

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Most likely written up from the same press handout as the Wessely “interview”, New Scientist, 13 March issue. 

From this morning’s Independent:

http://tinyurl.com/independentwessely

Tuesday 27 April 2009

What’s wrong with you? It depends where you live

Jeremy Laurance looks at how different countries treat the same symptoms

‘Simon Wessely, professor of psychiatry at Kings College, London, who has studied cultural trends in illness, says: “People will always seek explanations when they feel under the weather or not quite right. Much of it depends on what is currently hot in medicine. Each age and each culture has its own answers. Doctors use many different labels to describe patients with unexplained symptoms – somatisation, burn-out, chronic fatigue syndrome, multiple chemical sensitivity, subclinical depression, post traumatic stress disorder, low blood pressure, spasmophilia – despite no evidence that any of these are distinct or separate entities. Our belief is that most of these labels refer to similar clinical problems.”‘

Read full article in the Independent here

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You can send letters to the Editor for the print edition via email (full contact details will be required) to: letters@independent.co.uk  or leave a comment on the article. I’ve left the following comments, today:

Interests
Tuesday, 28 April 2009 at 07:26 am (UTC)

Does Professor Simon Wessely function as an external advisor to the American Psychiatric Association (APA) DSM Revision Process, other than his participation in the APA/NHI/WHO funded DSM-V Beijing 2006 diagnosis-related research planning symposium on “Somatic Presentations of Mental Disorders”?

and

Re: Mistreated by PSCYHOLOGY [sic]
Tuesday, 28 April 2009 at 01:52 pm (UTC)

This article bears such striking similarities to the “interview” published in New Scientist (Mind over Body? 13 March) that one suspects it has been written up from the same press handout.

And yes, once again, Professor Wessely disregards WHO ICD-10 taxonomy, using the terms “chronic fatigue”, “ME” and “Chronic Fatigue Syndrome (CFS)”, interchangeably, as though all three were indexed in the same Chapter of ICD-10, which they are not.

Only recently, the WHO Collaborating Centre, Institute of Psychiatry, was obliged to correct the website for the WHO Guide to Mental and Neurological Health in Primary Care where they had incorrectly placed “chronic fatigue” at G93.3. This website has now been amended to read “chronic fatigue G48.0” – which is still incorrect; it should read F48.0 (Chapter V).

It has sat like this for weeks. Would someone from the WHO Collaborating Centre or the Institute of Psychiatry or perhaps, Professor Wessely, himself, if he is reading these comments, please attend to this error?

Have a look at it here:

http://www.mentalneurologicalprimarycare.org/content_show.asp?c=16&fid=1252&fc=011065

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For the New Scientist “interview” with Professor Simon Wessely go to:

http://www.newscientist.com/article/mg20126997.000-mind-over-body.html

There have now been 564 responses in the Comments to this Wessely “interview”.  Two letters were printed in the magazine a couple of weeks after the article appeared – one by Dr Charles Shepherd, the other by Tom Kindlon; a further two letters have appeared in the print edition.  Prof Wessely has responded once, via the Comment facility, but author of the article, journalist Claire Wilson, has made no response.

Following the publication of today’s article in the Independent, I have added the following comments to the New Scientist:

Wessely In The Independent
Tue Apr 28 08:10:00 BST 2009 by Suzy Chapman

Very similar article in the Independent, today, and likely written up from the same press handout as this New Scientist “interview” with Prof Wessely.

http://tinyurl.com/independentwessely

Can anyone confirm whether Prof Simon Wessely functions as an external advisor to the American Psychiatric Association (APA) DSM Revision Process, other than his participation in the APA/NHI/WHO funded DSM-V Beijing 2006 diagnosis-related research planning symposium on “Somatic Presentations of Mental Disorders”?

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It’s All In The Definition
Tue Apr 28 09:24:42 BST 2009 by Suzy Chapman

Note that in the Independent article, Prof Wessely disregards WHO ICD classifications and again uses the terms “chronic fatigue” and “ME (myalgic encephalitis)” [sic] and “Chronic Fatigue Syndrome (CFS)”, interchangeably.

In the Independent article he comments on the term “Neurasthenia” – which he says is a diagnosis not used in Britain for a century.

Prof Wessely has a new co-authored paper published this month around the theme of “Neurasthenia”:

The relationship between fatigue and psychiatric disorders: Evidence for the concept of neurasthenia. Journal of Psychosomatics. Samuel B. Harvey, Simon Wessely, Diana Kuh, Matthew Hotopf

Abstract:

http://www.ncbi.nlm.nih.gov/pubmed/19379961

The Editor of the Journal of Psychosomatics is Francis Creed. Creed and Michael Sharpe are both members of the APA DSM-V “Somatic Distress Disorders” Work Group, aka the DSM-V “Somatic Symptom Disorders” Work Group.

Both Sharpe and Creed were members of the CISSD Project, administered by Action for ME. Dr Richard Sykes, who was the Co-ordinator of the CISSD Project, is now working on the “MUPSS Project” in association with the WHO Collaborating Centre, Institute of Psychiatry.

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