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History of Psychiatry & M.E.

This blog doesn't even touch on the severe harm caused by the Psychiatric Medical Profession to Patients with Myalgic Encephalomyelitis and whatever Chronic Fatigue Syndrome is meant to be. It doesn't cover the anguish of patients who were forced into Graded Exercise Therapy and Cognitive Behaviour Therapy, causing them to become severe and bedbound in dark silent rooms for decades or those who successfully left this world by their own ingenuity rather than to spend one more second of the horrific lives patients with Myalgic Encephalomyelitis are forced to endure.

Wendy Boutilier - Patient Advocate


Myalgic encephalomyelitis/Chronic Fatigue Syndrome has been a controversial diagnosis, resulting in tensions between patients and professionals providing them with care. A major constraint limiting progress has been the lack of a ‘gold standard’ for diagnosis; with a number of imperfect clinical and research criteria used, each defining different, though overlapping, groups of people with Myalgic Encephalomyelitis or Chronic Fatigue Syndrome.


This paper attempts to review basic epidemiological concepts to illustrate how the use of more specific and restrictive case definitions could improve research validity and drive progress in the field by reducing selection bias caused by diagnostic misclassification.


Even if we assume differences in methodology and geographical variations in prevalence, it is clear that rates are influenced markedly by the diagnostic criteria used. Brurberg et al. (2014) also showed that the Oxford criteria (Sharpe et al., 2015) yielded the highest median prevalence across studies, 1.5per cent, 15 times greater than that obtained using the Canadian criteria, albeit in different populations.


If it is assumed that the Oxford criteria always capture Canadian-positive cases, then, based on the above figures, we expect that of a sample of 15 cases selected using the Oxford criteria, 14 will not meet the Canadian criteria. Therefore, if Oxford-positive cases are used to test a hypothesis related to a specific pathophysiological process observed in Canadian-positive cases, this could lead to the selection of 14 non-cases (false positives) for every 15 recruited; an unacceptable level of misclassification.


A strategy for research the understanding of the significant impact diagnosis misclassification can have on policy and patient care will lead to new research opportunities as we embrace well-designed and powered studies that recruit patients compliant with more specific definitions and include detailed phenotyping of participants (Jason et al., 2015).


One approach to reducing misclassification in observational and interventional studies would be to improve specificity in case selection by, for example, requiring participants to simultaneously meet a combination of selected internationally agreed diagnostic criteria to be considered as cases. This would

· Minimise the recruitment of ‘spurious’ cases for studies;

· Avoid results that are difficult to interpret and represent a waste of precious resources;

· Avoid fallacies in the ‘evidence’, which have served neither patients nor health professionals.


A natural concern of using very stringent diagnostic criteria for research studies is that genuine cases could be excluded for not meeting inclusion criteria. While this can happen, the main consequence in analytical studies would be some reduction in study power, a price worth paying for a robust analysis that enables unbiased inference.


If more laborious recruitment is required (as many cases may not meet more stringent criteria for inclusion), any increase in study costs to achieve a given sample size would outweigh expenditure on research that is flawed by being too inclusive in recruitment of cases, but could generate spurious results.


Simon Wessely in this paper is trying to muddy the waters by connecting ME with affective disorders (Depression) as well as trying to introduce the idea of relabeling Myalgic Encephalomyelitis as Chronic Fatigue Syndrome even though in the 1992 FOI request letter quote above he is clearly saying that these are separate conditions.


Simon Wessely has given two talks for UNUM the insurance company. One was in London in 1995 and was about ME & CFS, the other was in 2007. This is a clear conflict of interest.


Peter White tries to justify deceiving patients into believing that they have CFS or CFS/ME knowing that ME is a very different illness; with the blind faith that it might improve recovery times from the illness even though he's admitting its considered incurable.


This fraud by misrepresentation is still going on with labeling Myalgic Encephalomyelitis (M.E.) as Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and breaks the Fraud Act of 2006.

How M.E has historically been portrayed as within conventional medicine and by governments around the world as a result of psychiatry's influence ?

Chronic Fatigue Syndrome - Oxford Definition

A report--chronic fatigue syndrome: guidelines for research.

"Fatigue is the principal symptom: it is severe, disabling and affects physical and mental functioning; it should have been present for a minimum of 6 months during which it was present for more than 50% of the time."


Michael Sharpe on the inclusion criteria for The Pace Trial.

"That is right all participants met criteria for CFS and a subset also for (one set of) criteria for ME. All had to have fatigue as the principle complaint. I hope clear in the paper" - Michael Sharpe admitting that people who qualified for a Chronic Fatigue Syndrome by the Oxford criteria were mixed up with people with Myalgic Encephalomyelitis (M.E.) on twitter.


"They would have excluded some of the epidemic cases yes, and rightly so. Whatever those epidemics where, they were not what we have all being calling CFS/ME for many years See section 12 of a chapter I wrote a quarter of a century ago. Still apposite" - Simon Wessely (01/05/209), 10:01 (tweet from twitter)

"I do agree that this terminology is unclear. It is what official bodies in the UK use. I apologise and agree that CFS and ME should be kept separate"

- Michael Sharpe (25/04/2018), 06:41 (tweet with Patient Advocate Guido Den Broeder)

In their editorial of 1st September BMJ 2007; 335:411-412 ”Chronic fatigue syndrome or Myalgic Encephalomyelitis NICE guidelines pave the way forward for patients and doctors", Peter White, Maurice Murphy, Jill Moss, George Armstrong, and Sir Peter Spencer state that:

"The uncertainty inherent in making a diagnosis of Chronic Fatigue Syndrome (CFS) is reflected by the variety of names (such as Myalgic Encephalomyelitis; ME) it has been given."


A particularly protracted period before reaching a conclusion may be indicative of uncertainty, the repetition of laboratory work may reflect uncertainty, the variety of tests employed might also signal doubt, and referrals to other specialists could be a sign of uncertainty. It is inconceivable that a “variety of names” signals diagnostic uncertainty.


This troubling claim appears in an editorial about a subject affecting millions of lives, and perhaps the authors would welcome this opportunity to clarify precisely what it is that they wish BMJ readers to understand by this claim ?


The authors continue that: "The names reflect the hope that such labels can impose some certainty where little exists"


Simon Wessely admitting that ME is not what they have been calling CFS/ME for all of these years.

"Dr. Wessely's work was mentioned. He has expressed his dissatisfaction with the guidelines and has written to the board to this effect. It was claimed that the DSS has misrepresented his work. He had included people with Chronic Fatigue Syndromes. There were other causes of this which people had recovered with exercise, whereas ME was made worse by exercise. The board had replied to Dr. Wessely and a copy of their reply was supplied to the ME representatives at the meeting" - from a Freedom Of Information (FOI) Request released Letter from 1992


Simon Wessely knows that "enteroviruses" were being thrown about as the triggering factor of Myalgic Encephalomyelitis in the late 80's as shown here; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(89)92679-2/fulltext


Other symptoms may be present: particularly myalgia, mood swings and sleep disturbances."

"Definite onset of symptoms, not life-long."


"Exclusions: patients with established medical conditions known to produce chronic fatigue; also patients with a current diagnosis of schizophrenia, bipolar disorder (manic depressive illness), substance abuse, eating disorder or proven organic brain disease."

There is a proven organic brain disease in Myalgic Encephalomyelitis, which disqualifies M.E. from the Oxford Criteria.


Other references.


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