Chronic fatigue syndrome

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c738 (Published 11 February 2010) Cite this as: BMJ 2010;340:c738
  1. Alastair M Santhouse, consultant in psychological medicine1,
  2. Matthew Hotopf, professor of general hospital psychiatry2,
  3. Anthony S David, professor of cognitive neuropsychiatry3
  1. 1South London and Maudsley NHS Foundation Trust, York Clinic, Guy’s Hospital, London SE1 3RR
  2. 2King’s College London, Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, London SE5 9RJ
  3. 3Section of Cognitive Neuropsychiatry, PO Box 68, Institute of Psychiatry, King’s College, London SE5 8AF
  1. alastair.santhouse{at}slam.nhs.uk

    Defeatism among clinicians is undermining evidence that it can be treated

    The recent acquittal of Kay Gilderdale, who had been charged with the attempted murder of her 31 year old daughter Lynn, has led to blanket press coverage this week. She was given a one year suspended sentence for the lesser charge of aiding and abetting suicide, to which she had earlier entered a guilty plea. The debate in the media has focused on the rights and wrongs of assisted suicide, the wisdom of bringing a prosecution for attempted murder, and whether the law needs to be changed.

    Yet perhaps the most striking aspect of the case from the clinician’s point of view is the largely uncontested media portrayal of a condition referred to as chronic fatigue syndrome or myalgic encephalomyelitis (now commonly if unsatisfactorily called CFS/ME) as a progressive, paralysing, and commonly fatal illness. Little has been said in the media about the uncertainties and controversies that this diagnosis has always attracted. The details of the Gilderdale case and the coroner’s inquest and postmortem are not available to us, so it would be inappropriate to comment on this specific case, and as in any criminal …

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