THE IMMUNOLOGICAL BASIS OF ME/CFS: what is already known? A compilation of documented immune system abnormalities in ME/CFS from 1983-2011 by Margaret Williams March 2012 Introduction There can be few practising health care professionals in the UK National Health Service who are unaware of the contentious battleground in which the disorder myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains mired even though it has been formally classified as a neurological disorder by the World Health Organisation since 1969, currently at ICD-10 G93.3. Essentially, there are two camps, one consisting of internationally renowned medical scientists and clinicians who acknowledge that ME/CFS is a multi-system neuro-immune disorder with protean symptomatology and who understand the extensive and compelling biomedical evidencebase that underpins the demonstrated organic pathophysiology. Given the extent of this international peerreviewed published evidence, one would have thought that no competent medical scientist, clinician or medical journal could credibly deny or reject the evidence that ME/CFS is a disorder of disrupted immune function, yet this continues to be the case. The second camp, a small group of UK psychiatrists and their adherents known as the “Wessely School” (Hansard: Lords: 9th December 1998:1013) choose to ignore this body of scientific evidence and they continue to subsume ME/CFS within their own construct of “CFS/ME” (which they insist is the same as “ME/CFS” or “ME” or “CFS” alone) and is defined by them as “medically unexplained chronic fatigue”. They assert that it is a functional (behavioural) disorder resulting from wrong attributions so is curable by “cognitive restructuring” (a form of brain washing intended to convince patients that they do not suffer from a physical disease but from “aberrant illness beliefs”), together with graded exercise to reverse their alleged “deconditioning”. The Wessely School believe that the more symptoms of which a patient complains, the greater the confirmation Invest in ME (Charity Nr. 1114035) that s/he is suffering from a psychogenic disorder and that the distressing symptoms are merely “hypervigilance to normal bodily sensations” and to “the perception of visceral phenomena” (The Cognitive Behavioural Management of the Postviral Fatigue Syndrome; S Wessely, et al; In: PostViral Fatigue Syndrome, ed. Rachel Jenkins & James Mowbray, John Wiley & Sons, 1991, page 311; Professor Peter White: Presentation to the British Neuropsychiatry Association, St Anne’s College, Oxford, December 2008). As key members of the Wessely School are advisors to Departments and agencies of State, it is their term and interpretation that is used by those agencies, as the Wessely School’s influence appears to be without limit when it comes to this disorder. The Wessely School’s intention is known to be to “eradicate” ME by dropping the “ME” from “CFS/ME” when expedient (Pfizer/Invicta: 4-5 /LINC UP, 15th April 1992; BMJ 2003:326:595-597) and then to reclassify “CFS” as a “functional” or behavioural disorder in the forthcoming revisions of both the WHO’s International Classification of Diseases (ICD–11) and the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5). Most of the Wessely School members also work for the permanent health insurance industry and have demonstrable financial interests in claiming “CFS/ME” as a functional disorder, since functional disorders are excluded from benefit payment. This unacceptable situation has for some years caused grave parliamentary concern (http://erythos.com/gibsonenquiry/Docs/ME_Inqu iry_Report.pdf). Notwithstanding, Professor Wessely has just published a paper in the Journal of Neurology, Neurosurgery and Psychiatry in which he appears www.investinme.org Page 29 of 108
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