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

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deconditioning caused their illness – it may be the result of the illness, and this very study supports such a
hypothesis.
If fatigue is perpetuated by deconditioning, one would expect that an activity programme that increases
performance in ME/CFS would increase fitness, but the Fulcher and White (1997) study had already
demonstrated no such relationship.
Of note is the fact that in his 2001 study, White made an “adjustment” to the data sets, stating:
“Because there were only 16 cases of empirical fatigue at 6 months, we added 26 cases of ‘fatigue not otherwise
specified’…Similarly, we added the 18 cases of ‘idiopathic chronic fatigue’ to the 17 cases of CFS according to the CDC
found at 6 months. These two categories defined participants with prolonged unexplained abnormal fatigue, but with
insufficient accompanying symptoms or disability to qualify for the full syndrome”.
Most crucially, idiopathic chronic fatigue is classified as a psychiatric illness in ICD‐10 at F48; similarly, it is
likely that “fatigue not otherwise specified” will contain people with psychogenic fatigue.
Such statistical adjustment clearly distorts the data, as it increases the values for psychosocial factors.
White continues to argue that both CBT and GET are effective treatments for ME/CFS and his work is
viewed as providing important evidence for this view, but the suggestion that GET can help post‐infectious
ME/CFS is not supported by White’s own data.
In summary, the evidence for the beneficial effect of GET in ME/CFS is not persuasive: if a sample of
ME/CFS patients contains a large number of patients with purely psychiatric reasons for their fatigue, then it
is hardly surprising to find that psychosocial factors are important – this is tautology and reveals little about
ME/CFS (with grateful acknowledgement to David Sampson for his analysis).
The above examples are merely illustrative of flawed methodology in Wessely School studies of “CFS/ME”.
International criticism by experienced ME/CFS researchers / clinicians has not abated, for example the
Preface to the book “Tuning The Brain” (Jay Goldstein MD; Haworth Press Inc., 2004) does not beat about
the bush: “I must say that the British CFS researchers (with very few exceptions), don’t know they don’t know and
wouldn’t care if they did. They seem to regard cognitive behavioural therapy as the Holy Grail of CFS”.
On 19 th June 2009 Dr Derek Enlander from New York was critical of psychiatrists who believe that graded
exercise therapy and cognitive therapy can be effective treatment. “We have found that graded exercise therapy
can actually be detrimental to the patient’s progress; it can actually produce relapse. Yet this is proclaimed by several
psychiatric experts to be the only mode of treatment,” he told IMT (Irish Medical Times). “This is very, very
damaging”.
It cannot be overlooked that the three PACE Trial Principal Investigators all work for the insurance industry.
Dr Jean Lennane, a psychiatrist, is outspoken about psychiatrists who work for the insurance industry:
“There are hired guns in other medical specialties, but they appear to be most frequent, and most vicious, in
psychiatry – probably because, as a ‘soft’ science, lacking the hard evidence of X‐rays and tissue
examination, psychiatry is more open to opinions, no matter how outrageous”
(http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/Lennane_battered.html).