Wessely at it again

Discussion in 'Fibromyalgia Main Forum' started by tansy, May 26, 2008.

  1. tansy

    tansy New Member

    Faculties Failure?

    Margaret Williams

    25th May 2008

    There can be few in the international ME/CFS community, either researchers or sufferers, who are not profoundly dismayed at yet another article co-authored by Professor Simon Wessely that fails to distinguish between patients with chronic fatigue and those with chronic fatigue syndrome.

    His article Physical or Psychological a comparative study of causal attribution for chronic fatigue in Brazilian and British primary care patients (Acta
    Psychiatr Scand May 2008: doi:10.111/j.1600-0447.2008.01200.x) fails to
    distinguish between chronic fatigue and chronic fatigue syndrome, the latter also being referred to as myalgic encephalomyelitis.

    For peer-reviewers of a highly-rated journal such as Acta Psychiatrica Scandinavica (which has an impact factor of 3.857, this being a high score, since 90% of journals score less than 1 on impact rating) to have allowed such blatant misrepresentation to have escaped censure is alarming.

    It is a matter of record that when serious errors and misrepresentations in his published articles (which, when challenged, even Wessely himself cannot
    rationally condone) have been pointed out to him and to Editors, Wessely blames his peer-reviewers. One instance of this occurred in 1997 in relation to his article in the Quarterly Journal of Medicine (The prognosis of chronic fatigue and chronic fatigue
    syndrome: a systematic review. Joyce J, Hotopf M, Wessely S. Q J Med 1997:90:223-233), the many flaws of which were exposed by Dr Terry Hedrick (a
    research methodologist) in a bullet-proof analysis that was published in Q J Med 1997:90:723-725. To quote Hedrick: Patients beliefs in organic bases for
    their illnesses may be more accurate than anything else we have to offer at this time. Not only did the Joyce et al article fail to summarize the psychiatric
    literature accurately, it omitted discussion of the many avenues now being explored on the organic underpinnings of (ME)CFS.

    This is not an isolated example of Wessely blaming his peer-reviewers. There have been others, for example, when UK medical statistician Professor
    Martin Bland from St Georges Hospital Medical School, London, pointed out significant statistical errors in a paper by Wessely and Trudie Chalder,
    saying that Wesselys findings were clearly impossible, Wessely absolved himself from any blame.

    Bland was robust: Potentially incorrect conclusions, based on faulty analysis, should not be allowed to remain in the literature to be cited uncritically by
    others (Fatigue and psychological distress. BMJ: 19th February 2000:320:515-516). Wessely was compelled to acknowledge on published record that his figures
    were incorrect: We have been attacked by gremlins. We find it hard to believe that the usually infallible statistical reviewers at the BMJ could have overlooked this and wonder, totally ungallantly, if we can transfer the blame to the production side.

    Will Wessely once again try to blame his peer-reviewers for this latest confusion and absolve himself from any blame? By what mental mechanism does he continue to dissociate himself from the fact that his personal belief that ME/CFS is a behavioural
    disorder is unsupported by hard evidence? Is he unmoved by the body of irrefutable evidence that has shown him to be wrong? That body of evidence is not
    going to go away. Why does he continue to deny it?

    How often must it be pointed out that it was in 1990 that the American Medical Association made it plain that chronic fatigue and chronic fatigue syndrome are
    not the same? The AMA statement said: A news release in the July 4 packet confused chronic fatigue with chronic fatigue syndrome; the two are not the
    same. We regret the error and any confusion it may have caused.

    And yet --- eighteen years later --- here we have Wessely and his co-authors still using the terms chronic fatigue and chronic fatigue syndrome and myalgic encephalomyelitis synonymously.

    Does this not amount to scientific misconduct?

    The title and the abstract of his latest paper refer to chronic fatigue but the text refers to chronic fatigue syndrome and ME.

    Given the fact that chronic fatigue is not synonymous with ME/CFS, the authors cannot possibly be talking about patients with ME/CFS, yet they claim to be doing so: Chronic fatigue syndrome (CFS), sometimes also known as myalgic encephalomyelitis (ME)..

    Once again, this is in rank defiance of the World Health Organisations International Classification of Diseases (ICD-10, 1992), which classifies fatigue quite separately from ME/CFS; moreover, the WHO
    has provided written clarification that it is not permitted for the same disorder to be classified to more than one rubric. Fatigue is classified as a mental disorder whilst ME/CFS is classified as a neurological disorder.

    Why is Wessely continually permitted to defy such international taxonomic principles?

    Unsurprisingly, this latest paper is replete with self-references.

    In it, Wessely states emphatically: British primary care patients with unexplained chronic fatigue were more likely to attribute their fatigue to physical causes than their Brazilian counterparts.

    Wessely acknowledges that: The study participants were not randomly selected representative samples from the healthcare seeking population yet his
    conclusion is categoric: Causal attribution influences symptom experience, help-seeking behaviour and prognosis in chronic fatigue syndrome.

    Wessely states: Less explored is a possible variation in causal attribution between sociocultural settings and to what extent physical attribution consistently
    associated with a poor prognosis of CFS is enhanced by sociocultural variables more frequently observed in Western affluent countries such as the UK. These
    include the sociopolitical debate about the nosological status of CFS in general and for disability benefits in particular.

    Somewhat unexpectedly, Wessely concedes that CFS is officially endorsed as a medical condition in the UK, citing A report of the CFS/ME working group:
    report to the Chief Medical Officer of an independent working group. Hutchinson A. cited 2007 September 23 (i.e. the Report to the CMO). This is notable, given that the original report of 11th January 2002 specifically omitted to accept the WHO classification of ME/CFS as a neurological disorder.

    If Wessely concedes that CFS is officially endorsed as a medical condition in the UK, why does he refer to it as unexplained chronic fatigue (UCF), which is a WHO classified mental disorder?

    It is a straight-forward enough concept, so once again it has to be asked what is it about this concept that Wessely seems so continually unable or unwilling to understand?

    In this latest paper, patients in the study with unexplained chronic fatigue were identified using the Chalder Fatigue Questionnaire, which is said to identify substantial chronic fatigue lasting six months or more. How this matches the criteria for ME/CFS such as the 2003 Canadian definition by Carruthers et al is not explained. The authors state: The questionnaires were read out to illiterate
    (Brazillian) participants. Those who fulfilled criteria for CFS were then asked to answer questions on causal attribution, duration of fatigue, and the Centre for Disease Control and Prevention (CDC) 1994 case definition of CFS.

    Furthermore, the authors state that they relied upon an estimated prevalence of chronic fatigue and on an assumed prevalence of UCF.

    Despite a study cohort that seems to be a conglomeration of ill-defined participants, Wessely et al state: More widespread awareness of CFS/ME in the UK may lead to a greater likelihood of British patients viewing their fatigue via a biomedical perspective than their counterparts in Brazil. In the UK, most media and self-help material provided by patient organisations are more likely to promote physical rather than psychological explanations (and) the health care system, which labels fatigue as a
    medical condition, may further reinforce this tendency.

    No reference is provided to support the assertion that the UK health care system labels fatigue as a medical condition.

    The authors state: Social support provided in a way which fosters dependency can help maintain chronic fatigue (and) there is an association between secondary gain and health outcomes (in) functional somatic syndromes.

    Wessely et al supply no references to support their claim, and seem to ignore the fact that both the Canadian and Australian guidelines reject such a notion.

    Despite Wesselys acknowledgement that there was a high non-response rate in the UK (Approximately 30% of the eligible patients in the UK did not complete phase 2 in comparison with only 6% in Brazil), the conclusion is that The higher availability of sick leave / sickness benefit because of CFS in the UK may both contribute to and reflect the greater legitimsiation of chronic fatigue as a medical
    disorder. The findings of this study lend some support to the evidence on the important role of sociocultural factors in shaping illness attribution and perception around chronic fatigue and chronic fatigue syndrome.

    It cannot be emphasised enough that unexplained chronic fatigue is not the same as ME/CFS.

    At the Second World Congress on CFS and related disorders held in September 1999 in Brussels, Dr Daniel Peterson from the US said that ten years ago
    (i.e. in 1989), he believed that (ME)CFS would be resolved by science, but that he had now changed his mind and believed that it could only be resolved by politics.

    It is politicians whom Wessely advises on CFS/ME and it is politicians who implement his advice, without seeming either to be aware of or to care about the enormous body of scientific evidence demonstrating that Wessely is simply wrong to lump chronic fatigue with ME/CFS as a single entity.

    Can it be right that politicians should now control the science of medicine? Wessely seems to think so. His latest paper seems to be saying that if Social Security benefits are stopped, patients will stop having ME/CFS.

    This contradicts the NICE Guideline on CFS/ME that was published in August 2007, which clearly said that it was the doctors job to support CFS/ME patients in obtaining benefits.

    It seems that Wessely disagrees.

    NB The abstract of: 'Physical or psychological?' - a comparative study of causal attribution for chronic fatigue in Brazilian and British primary care patients

    Journal: Acta Psychiatr Scand. 2008 May 22. Authors: Cho HJ [1], Bhugra D [2], Wessely S.[3]
    can be found at Co-Cure:
  2. Bluebottle

    Bluebottle New Member

    The Gibson report recommended eighteen months ago that the group of psychiatrists at the heart of the 'somatisation' labelling of M.E./CFS (the ones that grant themselves all the UK research & treatment money)be investigated for their links with private health insurance firms and with the department of work and pensions. This has not been done.The report specifically mentioned Simon Wessely.

    I wrote to the department of health to ask why, and was told that the government do not have to abide by the Gibson report's recommendations.

    Unum have specifically stated that they do not wish to have to pay out to M.E./CFS sufferers.It saves both the government and the insurance companies a fortune to have M.E./CFS misclassified as a psychiatric disorder.
    In addition to taking all the money for themselves, the psychiatric lobby here totally ignore any research that proves M.E. is a physical illness.

    The Gibson report also recommended that the £11.3 million pounds wasted on the CFS clinics (that treat M.E./CFS as a psychiatric condition,and whose GET and CBT make us worse)be equalled in spending on biomedical research.This has not been done; in the last twenty years all UK government research money for CFS/ME has been allocated to psychiatrists & the clinics have opened under their supervision.

    There has been a deliberate widening of the term 'CFS' to include anyone feeling a bit tired, in order to twist the research results of these psychiatrists.

    The situation here is scandalous & leading to enormous suffering, suicides and other deaths.

    Simon Wessely also claims that fibromyalgia, gulf war syndrome and lyme disease are just 'somatisation' (hysteria) disorders. He works for the military both here and in America. What is being covered up so very carefully?
  3. becc

    becc New Member

    It's interesting that Wessely chose Brazil for this comparison. It reminds me of a presentation I had to give at university - it was about a condition called 'nervos', which is essentially chronic hunger. The Brazilian government has psychologised the condition for political purposes, much like the British government has done with ME.

    Essentially, the physical symptoms of chronic hunger (which can include chronic fatigue and can be very similar to those of CFS) are no longer seen as being caused by a lack of food but rather by personal weakeness. That way, the government can deflect any responsibility for chronic hunger and instead blame the individual for being weak.

    I remember reading some case studies and the people suffering from 'nervos' seemed to have accepted that it was a psychological condition and not caused by something as simple as hunger. Given the apparently widespread acceptance of a psychological cause for these types of symptoms, I'm not particularly surprised that people in Brazil would be more likely to see the symptoms of chronic fatigue (/syndrome) as being manifestations of a psychological rather than physical illness.

    I've just found some of my notes for the presentation:

    "Patients believe doctors do not understand nervos, while doctors often believe their patients are somatising their conditions. One doctor claimed that “these people ‘enjoy’ being sick… Being sick makes the ‘little people’ feel important, valuable, long-suffering.”"

    Gee, where have we heard that before?

  4. saving to read later.

    love fran
  5. Rafiki

    Rafiki New Member

    With the acceptance of a biological bases for most, if not all, of the major mental illnesses psychiatrists are rapidly running out of conditions to treat in the way they have in the past. No one would suggest that a shrink try to talk someone out of their schizophrenia, for instance. It is a field of medicine in transition, for sure. I can't shake the feeling that Wessely, the man, is threatened by that.

    I really have no business saying that or assuming anything about him, but then, turnabout's fair play, isn't it.

    Peace out,

  6. quilp

    quilp New Member

    I think the guy has got serious psychological problems and should book an appointment with himself immediately :)
    Oh what a terrible legacy.........
  7. findmind

    findmind New Member

    I believe they should be sued in a class action lawsuit. The facts stated above are themselves brave ammunition towards proving a case.

    The CDC should also be sued in a class action. They have purposefully and purposely misdirected the distinction between CF and CFS, the same as the horrible dr. W.

    I am too tired to face all the criminal intent going on in the world now...

  8. Bluebottle

    Bluebottle New Member

    I wonder how much government research grant he had for this drivel, whilst Dr Kerr & Dr Gow get absolutely nothing.

    We are not allowed to know who sits on the Medical research Council, although they are funded by the UK taxpayer & spend over a billion pounds of tax payers money each year. My bet is that Wessley or White sit on it - the MRC have refused every application of funding for physical reseach into M.E./CFS
  9. jasminetee

    jasminetee Member

    I appreciate you all for keeping us informed about this. It is obviously all about money. Most definitely.

  10. Catseye

    Catseye Member

    It's either money or age. I've noticed the older a person gets, the less inclined they are to accept new ideas. Some people are real "cement heads".
  11. slowdreamer

    slowdreamer New Member

    I have heard doctors say this many times..It is not a field known for clear and rigorous thinking.
  12. simpsons

    simpsons Member

    sure he has mental health problems or why else like a nazi would he sanction the treatments of cbt and get when so much evidence shows it make at least 50% of people worse some never to recover.

    i have a bi polar friend who lives in an equal dreamworld where his logic is greatly impaired.

    he reminds me of a little hitler.
    he has been used by the government to cover up the camelford water pollution problem when alluminium was put into the water supply that was going directly to taps which made many people ill. the government didn't want the story getting our as they were going to sell them off and didn't want to lose onthe price.

    wessely called it mass hysteria despite the fact fish were dying lambs etc

    i hope one day he goes to prison for his fraud
  13. Bluebottle

    Bluebottle New Member

    Unfortunately for those who oppose them, psychiatrists have the most frightening powers of detention:


    What is going on?

  14. jasminetee

    jasminetee Member

    of the latter addy you gave say it all about the present state of affairs of the psychologizing of ME/CFS:

    "It was fourteen years ago, on 18th February 1993, that Dr Paul Cheney, Professor of Medicine at Capital University USA, Medical Director of the Cheney Clinic in North Carolina, and one of the world’s leading exponents on ME/CFS, testified before the FDA Scientific Advisory Committee in a testimony that has become one of the most quoted in history:

    “I have evaluated over 2,500 cases. At best, it is a prolonged post-viral syndrome with slow recovery. At worst, it is a nightmare of increasing disability with both physical and neurocognitive components. The worst cases have both an MS-like and an AIDS-like clinical appearance. We have lost five cases in the last six months. The most difficult thing to treat is the severe pain. Half have abnormal MRI scans. 80% have abnormal SPECT scans. 95% have abnormal cognitive-evoked EEG brain maps. Most have abnormal neurological examination. 40% have impaired cutaneous skin test responses to multiple antigens. Most have evidence of T-cell activation. 80% have evidence of an up-regulated 2-5A antiviral pathway. 80% are unable to work or attend school. We admit regularly to hospital with an inability to care for self”.

    "The Wessely School members promote themselves as leading experts in the field of ME/CFS, yet they do not appear to take account of major international research findings in that field and appear to disregard the research that has been carried out by top academics from many disciplines including immunology, neuro-endocrinology, virology, vascular biology, cardiology, infectious diseases, biochemistry and nuclear imaging. Since these self-acclaimed top academics appear to be unaware of the general body of knowledge known about by other clinicians and researchers working in the field of ME/CFS, at what point will that body of scientific knowledge be so great that it will be considered serious professional misconduct to pretend that it does not exist?"
    [This Message was Edited on 06/29/2008]
  15. Bluebottle

    Bluebottle New Member

    Thank you teejay. Despite all the research that's coming from America, the Wesselyite position in the UK is becoming stronger and stronger.
    It is firmly supported by the government who are saving themselves a fortune in benefit payment and treatment costs.

    The Wesselyites recommend that M.E. patients are tested for absolutely nothing in case any testing reinforces our 'aberrant illness beliefs'.
  16. tansy

    tansy New Member

    This is why the Wessley School have been so successful. The UK govt wanted to cut back on the numbers recieving sickness and disability benefits and so did the insurance industry.

    These psychiatrists saw their opportunity and jumped in with a solution.

    Now their mandate has broadened so other groups of chronically sick and disabled people are finding themselves in a similar position. This has led to growing concern amongst the govt's own advisors.

    tc, Tansy
    [This Message was Edited on 06/30/2008]
  17. jasminetee

    jasminetee Member

    I can't believe they won't even do testing. That's crazy. It's all about the almighty pound or dollar or Euro etc...

    That's a good article Tansy. I couldn't continue reading the comments though, especially when I got down to the person who says there's no evidence of biological abnormalities in CFS.

    My heart goes out to all of you across the pond and I hope we can turn this around soon.