It's not all in the mind

December 19, 2003

Symptoms of illness are often "unexplained" only because medical professionals are not carrying out enough exploratory investigations ("The medical mystery giving doctors a dose of humility", THES , November 14).

Chronic fatigue syndrome/myalgic encephalitis is a case in point.

Many seriously ill people are being offered nothing but cognitive behavioural therapy, graded exercise therapy or anti-depressants, despite increasingly solid evidence of the biomedical aspects of this illness and a recent protocol for diagnosis and management developed in Canada. Many doctors appear to accept uncritically a somatisation/ psychosomatic approach even though this has been shown to be detrimental to their patients.

There is a serious problem in the way chronic fatigue syndrome, classified as neurological by the World Health Organisation, has been excessively and inappropriately psychologised in Britain at the expense of acknowledgement of the biomedical aspects. Understand psychosocial aspects of health by all means, but do not forget the biomedical.

Angela Kennedy
Woodford Green, Essex

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