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General practitioners' perceptions of chronic fatigue syndrome and beliefs about its management, compared with irritable bowel syndrome: qualitative study

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.38078.503819.EE (Published 03 June 2004) Cite this as: BMJ 2004;328:1354

Re: Medical Correctness

The post by Dr Barrington Johnson , unfortunately, is rather
emblematic of the some of the more offensive attitudes present in some
doctors, which was actually highlighted in the Raine et al article.

Relying on opinionated, unsubstantiated generalisations such as
“Anyone who has dealt with (ME/CFS) knows..” and “a high proportion of
them have had deeply dysfunctional lives”, does not a reasonable and well-
informed clinical judgement make.

His faith in the North American DSM eventually validating his opinion
(above all others, by the looks of it) of ME/CFS sufferers as ‘deviant’
characters, rather than the seriously, bio-medically ill people that they
really are, is naïve at best: The DSM has been frequently and roundly
criticised for problems with reliability and validity. What is more, the
DSM has been subject to amendment in the light of such problems being
identified. (1) These issues, and the fact that the WHO ICD-10 retains
ME/CFS as the neurological illness that it is, plus the twenty or so years
of biological research that demonstrates it to be an organic illness,
might just deprive Dr Johnson of the comfort of his beliefs, and the myths
he appears to perpetuate himself. I did also find it rather ludicrous that
Dr Johnson seeks to include chronic pain in the DSM. If one follows his
logic cancer patients will be categorised as mentally ill for being in
chronic pain.

If Dr Johnson is typical of psychiatrists “treating” ME/CFS, than the
concerns of sufferers and their advocates about attitudes among doctors
are completely valid.

Doctors and other health professionals will have to face these
problems in medical practice. To ignore this particular problem, the
continued mistreatment of ME/CFS sufferers by too many doctors and
associated health professionals, will result in an inevitable loss of
confidence and standing in the medical profession, as such incidences
become more and more public. More sufferers may even take advantage of
legal proceedings or GMC investigation to ensure that those who misbehave
are held accountable.

I do hope that those doctors more enlightened about the inappropriate
treatment of ME/CFS sufferers and the appalling physical suffering they
experience will stand up and be counted over this issue. The wrongful
attitudes towards ME/CFS by those who follow the flawed logic uncovered
in the Raine article and elsewhere tarnish the whole of medicine. ME/CFS
sufferers badly need to feel that there ARE doctors who they can trust. At
present, despite the claims of some of the other contributors in this
Rapid Response section, the evidence is to the contrary. (2,3,4,5).

REFERENCES

1. Kutchins, H. Kirk, S.A. Making Us Crazy: DSM the Psychiatric Bible
and the Creation of Mental Disorders (1999) Constable, London.

2. TYMES Trust publication, “The Forgotten Children: A Dossier of
Shame” available online at:
http://www.tymestrust.org/pdfs/theforgottenchildren.pdf

3. Department of Health, A Report to the Chief Medical Officer from
the Independent Working Group on CFS/ME. 2002.

4.25% ME Group's 'Severely Affected ME (Myalgic Encephalomyelitis)
Analysis Report on Questionnaire issued January 2004', March 2004.

5. Saffin, K. Hackett, A. Wright, A Report of a consultation For the
MRC Research Advisory Group on CFS/ME, March 2003, Public Health Resource
Unit, Institute of Health Sciences, Oxford.

Competing interests:
Carer, Social Science Lecturer and Researcher,
Co-director, the ONECLICK Group

Competing interests: No competing interests

04 June 2004
Angela P. Kennedy
Social Sciences Lecturer
Essex IG8 9QX