By Diane O’Leary in BMJ Blogs.
Professional and public debate about myalgic encephalomyelitis/chronic fatigue syndrome(ME/CFS) has reached a new pitch. A London Times article in August described the “acrimonious scientific row” that’s erupted in the UK now that the US Institute of Medicine, National Institutes of Health, and Centers for Disease Control insist that ME/CFS is not a psychosomatic condition, but rather “a serious biological disease”. Just a few weeks ago the issue was raised in Parliamentary debate, with a long stream of MPs taking a vocal stand on behalf of their constituents with ME/CFS, demanding a new practice guideline that protects access to biomedical care. (To be clear, no biomedical treatments exist at this time. These MPs, and the patients they represent, demand access to biologically-oriented medical support, with symptomatic treatments and testing as indicated.)
For UK professionals in medicine, psychiatry and health policy, this is no minor scuffle. According to the Times, divisions over ME/CFS management have reached the level where one professional referred to another by email as a “disgusting old fart neoliberal hypocrite”. The trouble is that the UK is the conceptual home of the mental health approach to ME/CFS, and proponents of that approach are valued leaders in medicine and psychiatry. More than that, ME/CFS has long served within psychosomatic medicine as the quintessential psychosomatic condition, so a global reversal of opinion on this would shake the foundations of that field. This is no ordinary treatment debate.
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