Customer Reviews

Chronic Fatigue and its Syndromes

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In doing some research on CFS I ran across some information that counters assertions made by Wessely, et al.

From the Handbook on Human Performance, in the chapter on CFS and performance where it cites the results of the Sussex and Glasgow studies:

"There was clear evidence of slower motor performance, increased visual sensitivity, and memory defects in the CFS group.";

"It should be noted that CFS cannot be explained either directly or in terms of psychiatric disorder nor in terms of a psychological reaction to physical disease.";

"Results showed that none of the performance impairments could be attributed to psychopathology.";

"The CFS subjects were slower on a motor task, and performed attention tasks, logical reasoning, and semantic memory tasks more slowly and less accurately. These effects were obtained on both occasions which shows that the performance impairments associated with CFS are reliable over time.";

"These results confirm the general view obtained from the Sussex and Glasgow studies and show that the performance impairments observed in CFS generalize to different populations and may be detected using different methodologies."

From Dr. Bell's book, The Dr's Gude to CFS":

"CFS by design resembles psychiatric diagnoses more than traditionally defined medical disorders because it represents descriptive phemomenology" (Krupp). That is to say, a psychiatric diagnosis is suggested whenever description replaces technological measurements.";

"In the past, physicians have assumed that the fatigue of CFIDS is related to depression, and one characteristic of the fatigue of depression is that it improves with exercise. Thus physicans may have been recommending that patients take a brisk walk around the block every day or maybe take up jogging. Patients with primary depression may do well with this regimen, but patients with CFIDS stare at their physicians with a look of disbelief. Many try it only to find that it worsens their symptoms. To the patient, the symptom worsening confirms two things: 1.) that the physician has absolutely no idea of what he or she is talking about, and 2.) that the illness is not primary depression.";

"There is a simple way to prove that CFIDS is not somatization. With somatization, there may be numerous variable symptoms, but they are random. In CFIDS, the symptoms are not random, they form a specific pattern."

Wessley has a distinct bias which is apparently not shared by most of the top CFS docs and researchers. Maybe that is why he fudges his title.... rather rather than just using CFS in the title.

Dr. David Bell estimates that idiopathic chronic fatigue affects 25% of the population. Chronic Fatigue Immune Dysfunction Syndrome, a disease with clearly defined parameters and a devastating prognosis, is an entirely different thing. Like everyone else, Wessely has just turned blurred language into science, pretending to know something about a conditions which, most researchers now think, causes as much neurological impairment as AIDS dementia, greater functional severity than cancer or severe heart disease, and other horrible symptoms. I am nearly bedridden, and have been for seven years. Before that I was an athlete and scholar. I am sick of dealing with medical abuse, misogyny, and neglect around my illness. Never in the history of medicine has "guilty until proven innocent" been thrust so continuously on innocent victims of a horrible illness.

On the plus side, this book is indeed scholarly and highly referenced. On the down side, it is not WELL researched and fails dismally to meet some of the cardinal rules of good science: namely a process of stultifying rigour.

In fact it is poor, blinkered science. It represents (however meticulously) only one half of the complex truth that is CFS. I notice that one reviewer described as in the "dark ages". I would say that's not far off the mark. The scientific standing of CFS has moved on light years since DR Wessley and Prof. Weatherall (the reviewer who gave Dr Wessley's book high marks,) formulated their punitive theories. Anyone who does not believe that a large component of CFS is psychological, or can be very much helped by cognitive and behaviour therapies, would do very much better to look elsewhere for enlightened and scientific advice on how to approach recovery.

Along those lines I highly recommend Teitelbaum's book called Fatigued to Fantastic, and Burton Goldberg's book on CFS. Highly scientific, though concerned only with the neurological causes of CFS is Jay Goldstein's work. All of these books and many more are available from Amazon.

Finally a request to Dr Wessley (and Prof Weatherall). Please stop confusing fatigue syndromes with Chronic Fatigue Immune Dysfunction Syndrome. They are not the same thing and to make them into a single scientific enquiry is a nonsense.

Despite piles of new groundbreaking research on Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, these guys have decided that it's all a psychological disorder or just plain malingering. Their history of flawed and leading research is digusting and unprofessional and is laughed at my the educated researchers and health professionals who treat this serious disease. The medical community has been quick to label new diseases as purely psychological in the past including polio, multiple sclerosis and even AIDS. If you want to read about the "dark ages" view of CFS/ME, then read this book.

As a sufferer of Chronic Immune Dysfunction Syndrome i.e., Chronic Fatigue, I was apalled by the author(s) slant on this disease. While I believe that the course of every disease has some dependence on one's mental well-being, CIDS is very much a physical manifestation of a very debilitaing chronic disease.

I've suffered from CFS for over four years since a sudden onset triggered by influenza. Other than severe chronic fatigue I experience immunological defects including constant flu-like symptoms and feeling extremely frail and ill, sore throat, inability to control infection leading to constant periodontal disease and recurrent viral and fungal infections and extremely heightened allergic response. I also suffer from frightening deficiencies in cognitive ability (loss of mathematical ability, I mix up words, cannot remember simple phrases I want to use, dreadful concentration, etc), severe insomnia, severe depression, nausea, no circadian rhythm, pins and needles and numbness in my arms after walking short distances, intense sensitivity to sound and light (combined with cognitive defects this leaves me unable to even watch TV or listen to music), terrible digestion, stomach pains, muscle pain, headaches, and many more symptoms. I feel as if I've been poisoned or brain damaged by a virus. It is devestating enough to suffer this from CFS (an umbrella term which may represent more than one disease) without the nightmare being compounded by Dr. Wessely's theories of psychosomatic disease.

Here is a qoute from Professor Wessely:

"The description given by a leading gastro-enterologist at the Mayo clinic remains accurate. 'the average doctor will see they are neurotic and he will often be disgusted with them.'": Wessely S : Chronic fatigue and myalgia syndromes", in N. Sartorius et al (eds), 'Psychological Disorders in General Medical Settings', publ. Hogrefe & Huber, 1990.

The qoute can be found on this website: [local website]

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... I only give his book one star because I cannot give it zero, infact I'd rather give him a negative score.

In this book, Simon Wessely and his likeminded collegues demonstrate their notorious bias toward their demonstratably fallacious psychiatric paradigm for CFS. As usual, the only beneficiaries of their endevours include the medical insurance industry which has used this type of research to label CFS patients as suffering from psychogenic illness, conveniently allowing them to reject legitimate disability claims (ie, UNUM Provident citing Wessely's infamous collegue Dr Michael Sharpe) for one of the top five most expensive chronic conditions (UNUM, 1994), and also quite possibly the chemical industry too as it has been suggested by US biochemist Martin Pall that CFS shares the same causal biological pathways with Multiple Chemical Sensitivity, ie an elevated and self-sustaining overproduction of nitric oxide/peroxynitrite causing mitochondrial & cellular damage and physiological dysfunction. Whatever the cause of CFS is, there is enough evidence to demonstrate patients are suffering from serious physical disease: brain scans look the same as AIDS dementia; urine analysis yields potent neurotoxins whose levels corroborate symptom severity; blood volume is reduced to 50%-70% of normal; oxidative stress levels are sky high; mitochondrial DNA deletions; alcohol intolerance, etc. Another example of Wessely's sleight of hand that drew international condemnation includes his attempt to reclassify CFS as psychiatric using WHO logos in a Kings College (hospital) booklet. Why Wessely et al are handing a gift to the insurance industry and ruthlessly cashing in on the misery of of patients so sick they have been described as being as ill as someone with AIDS in the last 2 months of life is a matter for conjecture. I suggest that CFS patients should save their money and look up what Dr Paul Cheney, Professor Malcolm Hooper & Professor Martin Pall have to say if they wish to understand their disease.

The worst of both worlds: unscientific and boring.
Read Osler's Web Osler's Web: Inside the Labyrinth of the Chronic Fatigue Syndrome Epidemic, Hope and Help for CFS & Fibromyalgia or Fatigued to Fantastic instead

The howls of indignation generated within the 21st century industry of disease mongering by this excellent book are ample evidence of the power and cogency of the arguments put forward by its authors. Contrary to the opinion of some of the reviewers, this book most definitely does not state that chronic fatigue is best categorised as a psychiatric illness.

A decade since its publication, the research into this topic has generated nothing but a continuing plethora of epiphenomena that yield no logical framework for classifying this clinical presentation as the organic brain and muscle disease for which its advocates so desperately yearn. The overlap with other functional syndromes is clear and the authors have done a great service to the traditions of science and logic.

This is an excellent book! The researchers essentially examined every study ever conducted on CFS and related disorders and concluded that there is no merit to these diagnoses. One of the most interesting, yet not surprising, findings is that the largest predictor for poor prognosis is being part of a CFS support group. That is, people who belong to CFS support groups do not get better. Why? Because people who claim to have CFS and related syndromes are heavily invested in remaining in a sick role. Studies have shown that CFS is merely a manifestation of depression and that CFS complaints dissipate if you utilize therapy or anti-depressants that target depression. The angry reviews of this book are amusing. This is the only book that has conducted a thorough, empirical study on the phenomenon. It's not surprising that people who claim to have CFS would be upset by the results. The authors of this book had no incentive to find the results that they did and they do not take a side in the debate. They merely present a voluminous amount of data that simply doesn't support the diagnosis. Don't be mad at the bearers of bad news. Every person who works in the mental health field should own this book, it's an excellent resource.