Intended for healthcare professionals

Rapid response to:

Media Media

Diagnose and be damned

BMJ 1999; 319 doi: (Published 20 November 1999) Cite this as: BMJ 1999;319:1376

Rapid Response:

Sick and tired

EDITOR - It is understandable that TV entertainment should seek the
human interest, contrasts of opinion and a polemic approach. However, as
Harvey Markovitch points out in his recent review (1), television can also
fuel the fire of pressure groups bent on combating and discrediting
medical diagnoses and treatments. The Panorama programme of Monday 8th
10.00 " Sick and Tired" in which Drs Michael Prendergast and Alan Stanton
were the subject of "a hatchet job" is an example.

The Panorama programme implied that a psychiatric/rehabilitation approach
is of no use for children with CFS and that on the contrary it will be
harmful. It also gave the impression that many children seen by child
psychiatrists will be referred on to Social Services, forcibly removed
from their parents or inappropriately admitted to child psychiatric in-
units. None of this is born out by clinical or published evidence (2, 3,
4). Factual opinions given in the Panorama program were derived from an
unrepresentative sample of patient groups hostile to a psychiatric

There is in reality considerable affinity between the recently developed
recommendations on current best practice for the management of CFS by
Child and Adolescent Psychiatrists Services (3) and those developed by
patient groups.

I support H Markovitch's conclusions that defence societies should
consider defending doctors who are defamed publicly. In addition, highly
biased programs such as Panorama's are likely to scare families and deter
them from seeking the best help available and have the potential to do a
deal of harm. How is this monitored and audited by the BBC and other TV
companies? And how can medical practitioners help ensure a balanced
account when potentially controversial conditions such as CFS and child
abuse are

1. Marcovitch, H Diagnose and be damned. BMJ, l999, 319, 1376-

2. Fox, R A research portfolio on chronic fatigue. 1998. London:
The Royal Society of Medicine Press

3. Garralda E (Ed) Chronic Fatigue Syndrome: Helping Children and
Adolescents. 1999 ACPP, London

4. Rangel, L, Rapp, S, Levin M, Garralda E Chronic fatigue
syndrome: updates on paediatric and psychological management. (1999)
Current Paediatrics, 9, 188-193

Professor Elena Garralda

Professor of Child and Adolescent Psychiatry

Imperial College School of Medicine,
St Mary's Campus,
Norfolk Place,
London W2 1PG

Competing interests: No competing interests

28 November 1999
Elena Garralda