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BMJ No 7113 Volume 315 Letters Saturday 11 October 1997
Chronic fatigue syndrome in childrenAll studies must be subjected to rigorous scrutinyEditor,Over the years, the ME Association has noted that some of those writing in the BMJ make assumptions about the views of organisations concerned with myalgic encephalomyelitis. These assumptions concern the organisations' views about the aetiology and treatment of the disease. We wish to put the record straight as regards the position of the ME Association. We do not regard the mind-body issue as clear cut. We accept that, as in any long term disabling illness, symptoms will include both physical and psychological components, and we make this clear in our literature. We find unacceptable the often voiced assumption that our views on aetiology and treatment are coloured by prejudice against psychological illness or a wish to stigmatise such illnesses as less valid than physical illness. All illness, whatever the cause, is legitimate, and patients with that illness are worthy of respect and acceptance. Not all illnesses, however, share an aetiology, and not all illnesses respond to the same treatment. Both the report of a national task force(1) and a report by the royal colleges(2) noted that a substantial minority of those patients presently grouped under the term 'chronic fatigue syndrome' show no sign of past or present psychiatric disturbance. Clearly, in at least one subgroup of patients, psychiatric disturbance is not the primary cause of illness. This being so, it seems to us that opinion formers such as the BMJ must ensure that all views and all scientific evidence be presented for evaluation. The ME Association has no objection to studies such as the recent survey of schools being subjected to rigorous scrutiny and, if necessary, vigorous criticism.(3) This is part of the advancement of understanding. It must, however, apply to all studies presented, and our observations over the years have led us to believe that the BMJ has been guilty of a highly selective bias towards psychiatric studies, views, and editorials. We hope that this selectivity will now stop. We also hope that, should the BMJ wish to comment on the ME Association or any other organisation, it will contact that organisation and ascertain its view rather than publish unsubstantiated assumptions. Melanie Hume Chair
ME Association, References 1 National Task Force on Chronic Fatigue Syndrome (CFS), Post Viral Fatigue (PVFS), Myalgic Encephalomyelitis (ME). Report. Bristol: Westcare, 1994. 2 Joint Working Group of the Royal Colleges of Physicians, Psychiatrists, and General Practitioners. Chronic fatigue syndrome. London: RCP, 1996. (CR54.) 3 Dowsett E G, Colby J. Long-term sickness absence due to ME/CFS in UK schools: an epidemiological study with medical and educational implications. J Chronic Fatigue Syndrome 1997;3:29-42.
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