Bruce M Carruthers MD, CM, FRCP(C) (coeditor), Marjorie I van de Sande BEd, GradDip Ed (coeditor), Kenny L De Meirleir MD, PhD, Nancy G Klimas MD, Gordon Broderick PhD, Terry Mitchell MA, MD, FRCPath, Don Staines MBBS, MPH, FAFPHM, FAFOEM, AC Peter Powles MRACP, FRACP, FRCP(C), ABSM, Nigel Speight MA, MB, BChir, FRCP, FRCPCH, DCH, Rosamund Vallings MNZM, MB, BS, MRCS, LRCP, Lucinda Bateman MS, MD, Barbara Baumgarten-Austrheim MD, David S Bell MD, FAAP, Nicoletta Carlo-Stella MD, PhD, John Chia MD, Austin Darragh MA, MD, FFSEM. (RCPI, RCSI), FRSHFI Biol I (Hon), Daehyun Jo MD, PhD, Don Lewis MD, Alan R Light PhD, Sonya Marshall-Gradisbik PhD, Ismael Mena MD, Judy A Mikovits PhD, Kunihisa Miwa MD, PhD, Modra Murovska MD, PhD, Martin L Pall PhD, Staci Stevens MA
The label “chronic fatigue syndrome” (CFS) has persisted for many years because of lack of knowledge of the etiological agents and of the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term “myalgic encephalomyelitis”(ME) because it indicates an underlying pathophysiology. It is also consistent with the neurological classification of ME in the World Health Organization’s International Classification of Diseases (ICD G93.3). Consequently, an International Consensus Panel consisting of clinicians, researchers, teaching faculty and an independent patient advocate was formed with the purpose of developing criteria based on current knowledge. Thirteen countries and a wide range of specialties were represented. Collectively, members have approximately 400 years of both clinical and teaching experience, authored hundreds of peer reviewed publications, diagnosed or treated approximately 50,000 ME patients, and several members coauthored previous criteria. The expertise and experience of the panel members as well as PubMed and other medical sources were utilized in a progression of suggestions/drafts/reviews/revisions. The authors, free of any sponsoring organization, achieved 100% consensus through a Delphi type process.
The scope of this paper is limited to criteria of ME and their application. Accordingly, the criteria reflect the complex symptomatology. Operational notes enhance clarity and specificity by providing guidance in the expression and interpretation of symptoms. Clinical and research application guidelines promote optimal recognition of ME by primary physicians and other health care providers, improve consistency of diagnoses in adult and paediatric patients internationally, and facilitate clearer identification of patients for research studies.
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Science Versus Psychiatry – Again (22 July 2011)
Malcolm Hooper and Margaret Williams