You see him here, you see him there ..you see him everywhere

[Guest guest]

What follows is the text of the article entitled " The Views of Dr

Simon Wessely on M.E. : Scientific Misconduct in the selection and

Presentation of Available Evidence " by Eileen Marshall and Margaret

, published in the Spring 1994 issue of The CFIDS Chronicle.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

It is widely acknowledged in the peer-reviewed medical literature

that patients with myalgic encephalomyelitis (M.E.), otherwise known

as chronic fatigue and immune dysfunction syndrome (CFIDS) or

chronic fatigue syndrome (CFS), suffer from an organic illness which

is not psychological or psychiatric in origin. Persons with M.E. are

particularly vehement on this point because they know from

experience that selective symptoms which point to an organic

etiology are simply ignored by many in the medical community because

of ignorance or bias. One of the prime offenders in this category is

British psychiatrist Dr Simon Wessely.

It is very distressful that Wessely appears to be quite unstoppable

in his blind determination to claim that ME/CFIDS is nothing more

than a primary psychiatric disturbance.The only United Kingdom

government-funded research on ME/CFIDS has been a small grant to the

Medical Research Council, which went towards Wessely's research into

the psychiatric aspects of ME/CFIDS. In addition, Wessely has a

seemingly unassailable influence on the UK Department of Health and

the Department of Social Security, and the misinformation he is

propagating is causing immeasurable risk and hardship

to sufferers of ME/CFIDS.

His influence does not stop at the UK border, however. Wessely has

recently been in the United States doing his utmost to alter the

Centers for Disease Control and Prevention (CDC) criteria for CFS by

trying to get the case definition turned wholly away from an organic

etiology.

All ME/CFIDS patients should be adequately informed about the nature

and extent of the damage Wessely has done to them and the public

perception of this condition by his many publications in the medical

literature. We know that the accuracy of his quotations is not an

issue, as all have been published by Wessely and his close

associates.

" Maladaptive Coping Strategies "

Despite his claim that he does not want to get into the 'organic'

versus 'functional' argument [Wessley, S. - Editorial, 'Chronic

Fatugue Syndrome', Journal of Neurology, Neurosurgery and Psychiatry

1991;54:669-671] Wessely has done perhaps more than anyone else to

fan this particular flame. He believes that M.E. (or CFS as he

prefers to call this disease) is merely one end of a continuum

of 'tiredness' as experienced by everyone at some stage in their

lives, and that the prognosis of those who succumb to ME may " depend

on...maladaptive coping strategies. " [Wessely, S - 'The

Psychological Basis for the Treatment of CFS', Pulse of Medicine,

Dec 14th 1991; 58.] In other words, Wessely seems to be saying that

ME is nothing more than an attitude problem experienced by

suggestible people who are poor copers and see ME as an easy escape

route from life's problems. Wessely compares ME with Neurasthenia,

the late 19th century psychiatric disorder. He writes that

neurasthenia " provided the most respectable label... one which

conferred many of the benefits ... and fewest of the liabilities

associated with illness. ... There is little change in the current

era [of ME] " [Wessely,S.-'Old Wine in New Bottles', Psychological

Medicine, 1990;20:35-53.]

Unfortunately, and probably due to the input of doctors like

Wessely, ME definitions have recently centred on the symptom of

fatigue instead of the original definition of Ramsay, which focussed

on the rapid muscle fatigue after minimal exertion. Fatigue is too

vague and common a symptom on which to base any definition, but it

fits the aims of psychiatrists like Wessely who want to link ME with

depression.

Wessely's Scientific Methods

Wessely is a most prolific author, and to support his own views on

the nature of ME, he relies heavily on his own opinions; for

instance, in his chapter in a recent neurological textbook ['Recent

Advances in Clinical Neurology No.6', edited by C.Kennard, Churchill-

Livingstone,1990] he uses no less than 31 self-references. Most

mainstream medical journals will permit no more than two self-

references in an article.The extrapolations which Wessely makes from

his own research findings simply do not carry the weight to support

his conclusions. For the most part it seems he has reached his

conclusions before generating his data. One of his studies included

only 47 patients, yet from this small sample Wessely's major

conclusion is that " an alternative hypothesis is that all cases of

CFS can be explained by disorder of mood " [Wessely,S, ,R -

" Fatigue Syndromes: a comparison of chronic 'postviral' fatigue

with neuromuscular and affective disorders " , Journal of Neurology,

Neurosurgery and Psychiatry 1989;52.] In truth, this trial is too

small to be of any practical use and, by his own admission, his

methodology was flawed. Therefore his conclusions are baseless and

arbitrary. Even so, this study continues to be quoted by Wessely as

a paper of substance in the ME/CFS literature, as it was published

in the prestigious Journal of Neurology, Neurosurgery and

Psychiatry. This would undoubtedly convey considerable aumen if one

of his colleagues had not let it be known that Wessely himself is

the referee on ME for this journal (although he would not have been

permitted to review his own work). We understand that he also holds

this position for the British Medical Journal, The Lancet, and

various other peer-reviewed journals.

The Referee's Role

Normally, the identity of referees who perform peer-reviews is never

revealed, but there has been such concern over the abuse of the

referee's power to wield undue influence that Professor Sleight,

head of cardiology at the Radcliffe Hospital in Oxford

stated " Perr review is 50 per cent garbage, 50 per cent malice and

10% good advice " at a recent Royal Society of Medicine meeting.

[Feinmann, J - 'Can GP's trust what they see in academic journals?'

GP, 5th Nov 1993;53.] Professor Sleight went on to claim that " many

[referees] actually steal data and hold up publication while they

publish it as their own research. "

The role of referee on any particular subject carries enormous

responsibility, because he or she decides what gets published and

what gets rejected. If the journals are flooded with enough articles

which reinforce concepts of a particular disease, and when many of

the articles have been written by a single author, then two things

happen. One is that the ideas and conclusions repeatedly put forth

gradually become accepted as facts; the other is that the prolific

author becomes thought of as an 'expert' merely by virtue of the

sheer volume of his or her published works. It would then be natural

for such a prolific author to be sought out as the expert of choice

by lawyers, for instance. Professor Sleight told the Royal Society

of Medicine meeting that for his part, he prefers writing his own

detailed press releases rather than relying on the discredited peer-

review system.

Railroading the Opposition

Of more importance than his own personal views about ME is Wessely's

treatment of other people's genuine research into ME : he repeatedly

ignores, dismisses or trivializes any evidence which does not accord

with his own views. When he reviews the ME literature factual errors

(which lend support to his own theories) and he distorts other

people's accounts. For example, in one article [Wessley, S - 'Mass

Hysteria : Two Syndromes ?' Psychological Medicine 1987:17:109-120]

Wessely reduced the duration of the 1955 Royal Free Hospital

epidemic from the actual three months by claiming that it lasted

from one day to one month. He bases one argument on a 1970 review of

this epidemic [McEverdy CP & Beard, AW: 'Royal Free spidemic of

1955: a reconsideration.' British Medical Journal, 3rd January

1970;1:7-11, one of the most discredited papers in the history of

medicine -DK] which claimed that this outbreak was simply mass

hysteria, even though they had only reviewed old case notes and

failed to interview a single patient. Wessely states that McEverdy &

Beard felt that the use of the name 'benign myalgic

encephalomyelitis' in this epidemic served to reinforce the

outbreak. However, that name was not even coined until 1956, well

after the end of the outbreak [the infectious phase - DK] , so it is

unlikely that it could have influenced the course of the epidemic.

Further, there is no such reference by the original authors in the

McEverdy & Beard paper.

More recently, when discussing the persistence of viruses, Wessely

writes that even if a virus manages to evade the host response, " the

immune system still responds in such a fashion as to indicate the

presence of the virus. Evidence of any of these processes has not

been provided in CFS. " [Wessely,

S - 'The Neuropsychiatry of chronic fatigue syndromes', in Bock and

Whelan (eds) 'Chronic Fatigue Syndrome', Wiley & Sons / CIBA

Foundation, 1993]. The fact that Wessely chose to ignore the

extensive evidence found by..........................

Landsay AL, Jessop C, Lenette ET, Levy JA - 'Chronic Fatigue

Syndrome: a clinical condition associated with immune activation',

The Lancet, 1991;338:707-712.

Klimas NG, Salvato FR, R, Fletcher MA - 'Immunological

Abnormalities in Chronic Fatigue Syndrome', Journal of Clinical

Microbiology 1990;28:1430-1410.

on LJA, Behan WMH, Behan PO - 'Changes in natural killer cell

phenotype in patients with post-viral fatigue syndrome', Clinical

and Experimental Immunopathology 1991;83:441-446.

Chao CC, DeLahunt M, Hu S, Close K, PK - 'Immunologically

mediated fatigue - a murine model', Clinical Immunology and

Immunopathology, 1992;64:2:161-166.

JF, Ray CG, Minnich L, Hicks MJ, Kibler R, Lucas DO - '

Evidence for Activated EBV Infection in patients with persistent,

unexplained illnesses: elevated anti-early antigen antibodies',

ls of Internal Medicine, 1985;102:1-7.

Buchwald D, Cheney PR, DL, et al : 'A chronic illness

characterized by fatigue, neurologic and immunologic disorders and

active human herpesvirus type 6 infection', ls of Internal

Medicine, 1992;116:2:103-113.

.......................... does not mean that there is none [!] - it

only means that Wessely, as usual, restricts his references to a

biased and personal selection of the evidence which is available.

[Guest guest]

Thanks Angie.

This is not relevent; but was that expression originally about Robin Hood?

It was very familiar and his name just came to mind. Also during the French

revolution there was a nobleman whom used to help the French get out of France

- can't think of his name.

blessings

Shan

In a message dated 4/6/06 11:36:28 PM Eastern Daylight Time,

CFAlliance writes:>

> Date: Thu, 06 Apr 2006 00:41:59 -0000

>

> Subject: You see him here, you see him there ..you see him everywhere

>

> What follows is the text of the article entitled " The Views of Dr

> Simon Wessely on M.E. : Scientific Misconduct in the selection and

> Presentation of Available Evidence " by Eileen Marshall and Margaret

> , published in the Spring 1994 issue of The CFIDS Chronicle.

> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> It is widely acknowledged in the peer-reviewed medical literature

> that patients with myalgic encephalomyelitis (M.E.), otherwise known

> as chronic fatigue and immune dysfunction syndrome (CFIDS) or

> chronic fatigue syndrome (CFS), suffer from an organic illness which

> is not psychological or psychiatric in origin. Persons with M.E. are

> particularly vehement on this point because they know from

> experience that selective symptoms which point to an organic

> etiology are simply ignored by many in the medical community because

> of ignorance or bias.

[Guest guest]

The Scarlet Pimpernell!

nopace4me

>

> Thanks Angie.

> This is not relevent; but was that expression originally about

Robin Hood?

> It was very familiar and his name just came to mind. Also during

the French

> revolution there was a nobleman whom used to help the French get

out of France

> - can't think of his name.

> blessings

> Shan

>