PULSE, a magazine for general practitioners, recently included an article on a group of conditions that are often described as somatoform disorders and viewed as being psychiatric in origin. The inclusion of ME/CFS in the list has led a number of letters being sent to the editor of PULSE – click here. The MEA response, which has not yet been published, is set out below.
Almost all aspects of ME/CFS remain the subject of medical and public debate. PULSE therefore has a duty to provide balanced, accurate and up-to-date information to GPs in order to help them deal with the clinical assessment, diagnosis and management of what is complex and very heterogeneous condition.
Having read the recent contribution from Dr Christopher Bass (which clearly infers that ME/CFS is no different to any other somatoform/functional disorder, and is often maintained by abnormal illness beliefs/behaviour) along with the provocative follow-up editorial comments (which state that patients appear to have a problem accepting that they have a psychiatric illness which is often then labelled as being ‘all in the mind') I believe you have failed in this duty.
There is, in fact, a great deal of published research to support the World Health Organisation classification of ME (to which CFS is linked) as a neurological condition – a situation that is fully accepted by the Department of Health. Consequently, there are a number of non-psychiatric interventions which can help to alleviate symptoms as well as treatments under assessment that are aimed at the underlying disease process.
People with ME/CFS will, quite rightly, feel upset when they are told by GPs that their illness is ‘all in the mind' and that the only form of effective treatment is psychiatric intervention.
I hope that PULSE will therefore return to this topic in 2009 and use the opportunity to provide GPs with information that covers what is really happening with ME/CFS – for example, the new multidisciplinary expert group set up by the Medical Research Council to consider biomedical research strategies that now need to take place and the parliamentary inquiry into NHS services for this condition.
I have, incidentally, contributed to both PULSE and The Practitioner in the past on this subject.
Dr Charles Shepherd
Hon Medical Adviser,ME Association
7 Apollo Office Court