Saturday, January 16, 2010

An open e-mail to Professor M. McClure - retrovirologist at Imperial College

An open e-mail to Professor M. McClure - retrovirologist at Imperial College
London

(With thanks to Sheila Campbell on MEActionUK)

15th January 2010

With Reference to Wessely, Cleare and Collier's' Response on the PLoS One
Website

I found the following statement in Point 3 of Dr Anthony Cleare's response
(below) to be quite extraordinary:

"We follow the same psychiatric exclusion criteria as mandated by the Fukuda
criteria......In addition, we also exclude patients with chronic
somatisation disorder as defined by DSM-IV, which is not required by the
Fukuda criteria, but most experts and clinicians agree are a different
population."

Why extraordinary?

Because of Professor Wessely and colleagues' long held and widely publicised
view that CFS is a somatisation disorder (or medically unexplained syndrome,
MUS)(1)(2)(3)(4)(5)

This theory is promoted in complete defiance of the scientific evidence
which clearly shows CFS to be an organic disease. As such, by definition,
CFS cannot be a somatisation disorder.(8)(9)

Somatoform disorder is defined in DSM-IV as follows:

"The most common characteristic of the somatoform disorder is the appearance
of physical symptoms or complaints for which they have no organic basis."(6)

With such a profound turn around in thinking (if this really is the case)it
would be helpful to all concerned if the authors could please clarify the
following points:

1. Could you please state how all the authors defined CFS at the time of
carrying out this research and do you still hold that perspective?

Lombardi et al unequivocally, on the basis of the scientific evidence, view
CFS as an organic disease.

2. Could you please explain why you did not state in the paper that you had
excluded patients with somatoform disorders.

3. If, as you say, you excluded patients in this research who had
somatisation disorders, can you please explain why you cited papers in your
reference list (for example, reference 9 by Wessely et al, "Chronic fatigue
syndrome. A Practical Guide to Assessment and Management", 1997) which
clearly classes CFS as a somatisation disorder.

3. And could you please explain why you did not cite papers, such as in Ref
8 & 9 below, which clearly show the organic basis of this disease?

4. Could you please inform us when the 186 blood samples were taken, since
at least up until March 2009, Professor Wessely viewed CFS as a somatisation
disorder(2) You could ask Professor Wessely if the blood drawn from his
patients *after* he had changed his mind with Dr Cleare about CFS being a
somatoform disorder or if the blood was drawn before they both changed their
minds?

5.Could you please explain what has led to such a change of mind, no longer
viewing CFS as a somatisation disorder?

Thank you for your time.

.............................................................

REFERENCES
1.
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462005000300003

Chronic fatigue syndrome: an overview.
Cho HJ, Wessely S.
Rev. Bras. Psiquiatr. vol.27 no.3 São Paulo Sept. 2005 "Chronic fatigue
syndrome is an exemplar of a medically unexplained syndrome."

"Similarly, functional somatic syndromes refer to groups of symptoms lacking
disease-specific, demonstrable abnormalities of structure, and are usually
defined by specialty or organ system. They include irritable bowel syndrome,
fibromyalgia, chronic fatigue syndrome, multiple chemical sensitivity,
chronic pelvic pain, temporomandibular joint dysfunction and more recently
Gulf War syndrome."

This paper is titled "CFS: An Overview" yet please note that the
references,(consisting of 6 papers) do not include any papers on biomedical
research.

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

New Scientist, Opinion, "Mind over body?", Professor Simon Wessely, 13 March
2009. Please note that there is no mention of all the biomedical research
showing CFS to be an organic disease, hence readers may understandably have
thought that it does not exist.

3. http://www.iop.kcl.ac.uk/vacancies/downloads/0740.pdf

Research carried out at the Institute of Psychiatry, Kings College London,
where three of the authors of this paper are based.

Part 4 - The Project and the Post "Background: Anorexia Nervosa (AN) and
Chronic Fatigue Syndrome (CFS) are classical psychosomatic
disorders......Aberrant emotional processing is a strong candidate as a
maintaining factor for these disorders."

4. http://www.meactionuk.org.uk/Corporate_Collusion_2.htm

From "Corporate Collusion?" by Professor Malcolm Hooper, Eileen Marshall and
Margaret Williams, comments made by Professor Wessely over the years about
CFS and CFS patients clearly showing how he views these patients and the
disease:

"Wessely is on record as asserting that ME is merely a "belief" held by
those who think they suffer from it; that ME patients' muscle weakness is
"simulated"; that efforts are made to over-interpret laboratory findings;
that the average doctor will see ME patients are neurotic and will often be
disgusted with them; that blaming a virus for the illness conveys advantages
by protecting the victim from personal blame; that symptoms are simply
normal sensations and are the result of "body-watching"; that ME is a
"myth"; that ME is "learned helplessness"; that once validation is granted
by a doctor, the ME patient may assume the "advantages of the sick role --
sympathy, time off work, benefits etc"; that ME symptoms have no anatomical
or physiological basis; that patients' aberrant beliefs are maintaining
factors and that patients with ME exert a large and avoidable financial
burden on health and social services.

(For individual references, see the December 2003 Briefing Paper for the
House of Commons Health Select Committee: The Mental Health Movement:
Persecution of Patients? which is available online at
http://www.meactionuk.org.uk/SELECT_CTTEE_FINAL_VERSION.htm  )."

5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539474/

Medically Unexplained Symptoms: Exacerbating Factors in the Doctor-patients
Encounter, L A Page, S Wessely, Journal of the Royal Society of Medicine
2003:96:223-227 "This term (MUS) is now used in preference to "somatisation"

However I cannot find MUS in the DSM-IV

6. http://www.psychnet-uk.com/dsm_iv/somatization_disorder.htm

Definition of somatisation disorder

7. http://www.meactionuk.org.uk/Wesselys_Way.htm

"Wessely's Way: Rhetoric or Reason?"
Professor Malcolm Hooper and Margaret Williams 22nd March 2008

8. http://www.meactionuk.org.uk/Research_References_Update_Dec_08.htm

List of reference and abstracts for some of the many biomedical research
papers on CFS, plus inquest and autopsy information, see item 47 and 48.

9. Two further important references, 2009.

http://www.ncbi.nlm.nih.gov/pubmed/19955554?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

J Clin Pathol. 2009 Dec 2.
Microbial infections in eight genomic subtypes of Chronic Fatigue Syndrome /
Myalgic Encephalomyelitis (CFS/ME).
Zhang L, Goudh J, Christmas D, Mattey D, Richards S, Main J, Enlander D,
Honeybourne D, Ayres J, Nutt DJ, Kerr J.
St George's University of London, United Kingdom;

http://www.ncbi.nlm.nih.gov/pubmed/19909538?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

J Transl Med. 2009 Nov 12;7:96.
Plasma cytokines in women with chronic fatigue syndrome.
Fletcher MA, Zeng XR, Barnes Z, Levis S, Klimas NG.


......................................................................

http://www.meactionuk.org.uk

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