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Controversial health article

Saturday 2 May 2009

The Independent An article by Jeremy Laurance in UK newspaper The Independent has generated plenty of angry responses.

The article begins unpromisingly with the title "What's wrong with you? It depends where you live":

Human beings may belong to the same species, but they experience sickness differently. Each nation has its favoured illnesses and its favoured explanations, which alter over time. A doctor in one country may label an illness as depression, while the identical symptoms may be labelled as low blood pressure in another, or as the effects of dental amalgam in yet another.

ME/CFS is mentioned in the article with this:

Britain and France: chronic fatigue and spasmophilia

French doctors do not recognise the condition known as ME (myalgic encephalitis) or Chronic Fatigue Syndrome (CFS), which is widely known and frequently diagnosed in Britain. Often the condition is triggered by a viral illness, such as glandular fever. Most people get over it but some become trapped in monitoring their symptoms, restricting their activities beyond what is necessary and getting demoralised.

Professor Wessely, a specialist in the problem, said: "In Britain, people with chronic fatigue think that if they do too much the virus that caused it is still there and will come back and make them worse. That is catastrophising the illness. They don't think like that in France and they don't have the same outcomes. It is how you respond to symptoms that determines the outcome."

He described how a French physician from Lyon who spent a sabbatical in the UK was astonished at the sight of children with chronic fatigue in wheelchairs at Great Ormond Street hospital. "He returned to Paris and wrote an article about how there was just no equivalent in France."

In place of chronic fatigue, the French suffer from spasmophilia – panic attacks characterised by hyperventilation, spasms and convulsions. Young women are again particularly vulnerable and, as with sufferers from chronic fatigue, often dissatisfied with their medical treatment. Spasmophilia is not recognised elsewhere.

It's the above passage that has prompted an avalanche of scorn in the Comments section. This comment from Peter Evans is typical:

What's wrong with you Jeremy Lawrance?

It's clear that the author Jeremy Lawrance has no personal experience of living with ME/CFS/MCS and the multiple associated problems, particularly when trying to access well informed health care. He also has not bothered to do even the most basic research for this article, which is highly offensive to people who actually live with these complex conditions.

Dr Simon Wessely is well known to the international ME/CFS/MCS community. The promotion of his unproven and inaccurate psychological theories have for many years caused immense suffering and prevented proper scientific investigations and medical managment of this very serious and growing public health issue. The media has also been guilty of tagging along on this psychobabble band wagon without adequately investigating the facts.

People with ME/CFS/MCS face immense discrimination in society and are often denied access to even the most basic services such as health care and housing due to the kind of general ignorance that is being promoted in this article. As pointed out by other commentators below the medical neglect facing people with ME/CFS/MCS can be life threatening.

Shame on The Independent for publishing this rubbish.

From Peter Evans, former Registered Nurse and survivor of ME/CFS/MCS for over 25 years.

Even Dr Charles Shepherd weighed into the discussion with his letter of response to The Independent:

There really is ME in France

While I agree that many French doctors still refuse to accept that ME/CFS exists as a distinct clinical entity, this situation cannot be used to conclude that the illness is not present in France ("What's wrong with you? It depends on where you live", 28 April).

A proper epidemiological study (The epidemiology of fatigue and depression: A French primary care study. Psychological Medicine. 25 (5) 895-906, September 1995), which investigated the prevalence of persistent fatigue in France, found that this is a significant and common presenting complaint in primary care. Here at the ME Association we are regularly contacted by people in France who are desperately seeking help with regard to both diagnosis and management – some of whom appear to be receiving inaccurate explanations for their persisting ill health.

The simple fact is that if people with ME/CFS do too much and exceed their limitations – as may be advised by doctors who believe the problem lies in abnormal illness beliefs and behaviour. – they invariably feel worse as a result. The key to recovery in ME/CFS is careful pacing of activities, a process involving small but flexible increases in activity that take account of the person's limitations.

All of which is consistent with the neurological abnormalities that have led the World Health Organisation to officially classify ME as a neurological disorder (in section G93.3 in ICD10).

Dr Charles Shepherd

Hon Medical Adviser, M.E. Association, Gawcott, Buckinghamshire



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