ME Association challenges Pulse Learning’s classification of ME/CFS as a mental health disorder | 21 August 2016

The ME Association has today asked the medical education website Pulse Learning to stop classifying Chronic Fatigue Syndrome (CFS) as a mental health disorder. Pulse Learning has just published a new learning module on CFS and listed it in its mental health section.

Our medical adviser, Dr Charles Shepherd, has sent this email to Pulse Learning:

Dear Pulse Learning

Re Case based learning on CFS: http://pulse-learning.co.uk/clinical-modules/mental-health/cfs-case-based

I am not currently registered with PULSE to do your CPD learning modules and have not therefore gone through this new learning module on ME/CFS.

I am, however, very concerned to see that this module has been incorrectly inserted into the ‘mental health' section of your learning modules.

As I am sure the authors of the module are aware, ME is classified as a neurological disease by the World Health Organisation (WHO) in their International Classification of Diseases (>> ICD10 section G93:3) and that this WHO neurological classification is accepted by the Department of Health, NHS etc. CFS is linked to this ME classification in ICD10.

In addition, the most recent report – Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – on ME/CFS from the Institute of Medicine in America states quite clearly that ME/CFS (or systemic exertion intolerance disease/SEID – as they have recommended as a new name for ME/CFS) is not a psychological or psychiatric condition. It is a complex multisystem medical disease.

IoM Report:
http://www.nationalacademies.org/hmd/Reports/2015/ME-CFS.aspx

There are obviously disagreements and uncertainties surrounding many aspects of ME/CFS.

However, if GPs are going to immediately start off by working on the incorrect basis that they are dealing with a mental health/psychiatric condition, this will not only lead to conflict with patients. It will also lead to inappropriate and possibly harmful advice on management.

I will try and look at the module during the coming week.

In the meantime, please could it be inserted into a section covering neurological and/or immunological disease – where it belongs.

WE'VE NOW HAD THIS EXCHANGE OF EMAILS WITH DR DAVID SWAN, THE CLINICAL EDITOR OF PULSE

22 August

Hi Dr Shepherd,

Thanks for your email about the CFS module. I have added a neurology category to the module, but have kept the mental health tagging on it as well, so it will now sit in both specialties.

Kind regards,
David

David Swan
Clinical editor, Pulse
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23 August

Dear Dr Swan

Thank you for relocating this module into neurology.

However, it should NOT be in mental health at the same time and should therefore be removed from this mental he alth tagging as well.

I will have a look at the complete module later in the week because, as I'm sure you are aware, the are major concerns in the patient community about:

1 the length of time it takes for a diagnosis of ME/CFS to be made – hence our 2016 campaign on early and accurate diagnosis:

The Importance of Early and Accurate Diagnosis | Helpful hints for healthcare professionals that could improve prognosis | 9 May 2016

2 misdiagnosis

3 harmful or inappropriate advice on management

4 lack of NHS referral services in many parts of the UK – they are almost non existent in Scotland, Wales and Northern Ireland (and the Isle of Man)

5 the appalling situation regarding the lack of practical support along with the medical neglect of many people who are severely affected by ME/CFS

These are all important issues relating to primary care that PULSE magazine might like to pursue?

Regards

Dr Charles Shepherd
Hon Medical Adviser, MEA
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