Intended for healthcare professionals

Rapid response to:


Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds: cross sectional study

BMJ 2003; 327 doi: (Published 18 September 2003) Cite this as: BMJ 2003;327:654

Rapid Response:

The Doctor must not close his or her mind to all possible factors in regard to treatment

While Dr Cosgrove made some interesting points in regard to his
therapeutic approach, there are certain problems which remain unanswered:
Firstly, his generalisation that CFS/ME children are anxious children. All
of them? And why might they be anxious? Does not unexplained serious
illness make people feel anxious, whether they be children or adults? What
is meant by 'anxious', and where does anxiety become 'abnormal'? These are
important issues to delineate in any diagnosis, surely?

Secondly, are all CFS/ME patients therefore, victims of
psychiatric/psychosomatic disorder, or is there a biological cause at
least sometimes at work, a possibility, indeed probability which a large
international body of evidence points to? Does this not mean, therefore,
that DOCTORS need to keep their minds open?

Thirdly, how can intelligent, diligent children who do NOT get bored
easily, and are rational enough to make decisions to do what they are
asked, fit into the generalised 'some children' description proposed?

And last, but not least, are sufferers themselves, or parents of very
sick children, not allowed to have opinions on academic works, or engage
with the evidence, or the doctors within a relevant debate? Are we not to
question what we are told, not to use our evaluative skills to critically
analyse what we feel might harm ourselves or our children further?

I'm afraid I WAS rather offended by Dr Cosgrove's second guessing as
to my opinion and the opinions of other contributing to this debate.
Please do not seek to belittle us. We have no hidden agenda, no need for
power or status, we only want what is the best option for ourselves or our
loved ones, and to the best of my knowledge, this does not signify deviant
or inappropriate attitudes on our part.

Competing interests:  
None declared

Competing interests: No competing interests

28 September 2003
Angela P. Kennedy
Carer, Lecturer and Researcher
Open University