What the Heck are They Talking About: Neurological CFS

Reality bites - biopsychosocial

The dream:

"The research is clear--any division between mind and body is arbitrary, capricious and detrimental to the health of individuals, family, communities and our nation." 1

Norine G. Johnson
APA past-president

The reality:

"Those who cannot be fitted into a scheme of objective bodily
illness yet refuse to be placed into and accept the stigma of mental illness remain the undeserving sick of our society and our health service." 2

Michael Sharpe
UK Psychiatric specialist

1. Monitor on Psychology, Fusing mental health and health; Volume 33, No. 10 November 2002

2. University of Strathclyde, October 1999

Just a hysterical belief that disgusts doctors?!

hys·ter·i·a  n

a state of extreme or exaggerated emotion such as excitement or panic, especially among large numbers of people

19th Eliot Slater Memorial Lecture at The Institute of Psychiatry Kings College in London:

"I am going to talk not about an illness but about an idea. There is a phenomenon known as myalgic encephalomyelitis - or ME.... I will argue that ME is simply a belief, the belief that one has an illness called ME. Right from the start, ME has been identified with a refusal to accept the doctor's verdict. Neurasthenia was the disease of modern life --- so is ME.... There is another condition with which ME might easily be confused - it is hysteria."

Dr. Simon Wessely
12th May 1994

"The description given by a leading (doctor) at The Mayo Clinic remains accurate: 'the doctor will see that they are neurotic and he will often be disgusted with them' "

Chronic fatigue and myalgia syndromes. Wessely S. In: Psychological Disorders in General Medical Practice. Eds. N Sartorius et al Hogrefe & Huber 1990

C'mon Simon, don't sugar coat it like that, tell us what you really think.

Myalgic encephalomyelitis (ME), the original medical term for CFS, has been classified by the World Health Organization (WHO) as a neurological disorder since 1969 as has post viral fatigue.

Chronic Fatigue Syndrome (CFS/ME) is the generic, clinically watered down term in use in the United States since 1988. Like ME, CFS is also classified by the WHO under neurological disorders (ICD - 10 G93.3).

WHO specifically excludes the concurrent classification of ME/CFS under (ICD 10 F48) as neurasthenia. The clinical appropriateness of the inclusion of neurasthenia in the ICD 10 is also questioned.

In view of questionable clinical validity, neurasthenia was omitted from the 3rd edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980.

Clinical Validity of ICD-10 Neurasthenia; Bettina Bankier, Martin Aigner, Michael Bach Department of Psychiatry, Division of Social Psychiatry, University of Vienna, Austria
Psychopathology 2001;34:134-139 (DOI: 10.1159/000049296)