MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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evidence for a specific persistent infection” (LD Devanur, JR Kerr. Journal of Clinical Virology 2006:
37(3):139‐150), but the Wessely School have consistently argued that no investigations should be performed
to confirm the diagnosis (for example, in the Joint Royal Colleges’ Report on CFS, CR54, 1996). Following
publication of that report (which was internationally condemned for its extreme psychiatric bias and of
which Professor Simon Wessely was understood to be the prime mover), the Editor of the Lancet, Richard
Horton, courageously spoke out against it: “The college representatives interpreted every piece of evidence
pointing to a biological cause in a negative light. Medical paternalism seems alive and well in Britain
today” (“Why doctors are failing ME sufferers”. Dr Richard Horton. Observer Life, 23 March 1997).
There is now laboratory evidence of organic disease in ME/CFS, yet these psychiatrists continue to dismiss
or ignore it and, at a cost to UK taxpayers of over £11.1 million, pursue their own belief that “CFS/ME” is a
functional somatic syndrome that is amenable to, and even curable by, behavioural modification techniques.
That the Wessely School remain intransigent in their beliefs about ME/CFS can be seen, for example, in the
American Family Physician, a peer‐reviewed journal of the American Academy of Family Physicians (which
is one of the largest groups of physicians in the US). The issue of 1 st November 2005 (volume 72, no. 9)
featured CFS in the section “Clinical Evidence Concise”, this being a section that purports to provide
evidence‐based continuing medical education (CME) for the credits that are required to be obtained by all
physicians to demonstrate their up‐to‐date medical knowledge.
Articles in “Clinical Evidence Concise” purport to summarise current knowledge about a disorder and are
used in “best practice” guidelines.
In that particular issue, the authors of the CFS article were Steven Reid, Trudie Chalder, Anthony Cleare,
Matthew Hotopf and Simon Wessely. What was so disturbing was that the article was a re‐run of the same
authors’ paper in the BMJ of January 2000, which itself was a shortened version of their article in the second
issue (December 1999) of “Clinical Evidence”, a BMJ Publishing Group Review. For these authors to have
published it again six years later demonstrates their refusal to pay any heed to the wealth of biomedical
evidence about ME/CFS that had been published in the intervening years.
As Jill McLaughlin noted on http://health.groups.yahoo.com/group/
MEActionUK/ : “This is what is being distributed to physicians all over the country who legitimately use
evidence‐based medicine to treat (or in this case, shall we say, mistreat)
patients. We cannot always rail at doctors when this is the information that they are receiving in mainstream, peer‐
reviewed medical journals”.
It is known that, although not yet published, the results of the FINE Trial (the sister trial to the PACE Trial
that was funded entirely by the MRC) have shown that “pragmatic rehabilitation” (PR, based on CBT/GET)
was minimally effective in reducing fatigue and improving sleep only whilst participants were engaged in
the programme and that there was no statistically significant effect at follow‐up. Furthermore, pragmatic
rehabilitation had no statistically significant effect on physical functioning; equally, its effect on depression
had diminished at follow‐up. Moreover the other intervention being tested (“supportive listening” or SL)
had no effect in reducing fatigue, improving physical functioning, sleep or depression.
Notwithstanding, the investigators are already seeking further funding to test their hypothesis that
providing more sessions might improve the effectiveness of pragmatic rehabilitation which they state “will
inform the next phase of our work….The first phase of this work will be in conjunction with the Greater Manchester
CFS Service” (two FINE Trial case histories can be found in Appendix VIII).
Is this another illustration of the Wessely School’s determination not be deterred by evidence that does not
suit their own “evidence‐based” agenda? To the on‐going detriment of people with ME/CFS, it appears to
remain the case that, supported by the MRC, the Wessely School continue even now to disregard the
empirical evidence and to pursue their own behavioural model of “CFS/ME”.