Peter D. White is a British psychiatrist. He is Professor of Psychological Medicine, honorary consultant liaison psychiatrist at St Bartholomew's hospital and co-leads the chronic fatigue syndrome (CFS) service. Prof White was the lead investigator on the PACE trial. Prof White also funded and was involved in the Cochrane review of GET.
Links to Insurance Industry
Peter White has consulted for the insurance industry. He did not disclose his financial conflicts of interest to the participants of the PACE Trial, of which he was the lead investigator. David Tuller has written critically about the links the PACE trial investigators have to the insurance industry.
Prof White resigned from clinical practice just before he was compelled by an order of the court to release the raw data from the PACE trial.
- 2017, Response to: "Do more people recover from chronic fatigue syndrome with cognitive behaviour therapy or graded exercise therapy than with other treatments?"
"ABSTRACT - Background: Wilshire et al. suggest that we have overestimated the number of patients that recover from chronic fatigue syndrome (CFS) after receiving a course of either cognitive behaviour therapy (CBT) or graded exercise therapy (GET), as reported in a secondary analysis of outcome data from the Pacing, graded Activity and Cognitive behavior therapy; a randomized Evaluation (PACE) trial. We provide counter-arguments to this view. Purpose: To provide an alternative view to that offered by Wilshire et al. Methods: We review the two different analyses of PACE trial outcome data to estimate recovery, and compare these to other published trials and cohort studies. Results: While there is no gold standard for recovery from CFS, previous trials and cohort studies provide support for our analysis of recovery in the PACE trial. Our finding that 22% of participants recover from the current episode of CFS after either CBT or GET, compared to 8% after adaptive pacing therapy and 7% after specialist medical care alone, is consistent with the literature. Conclusions: Our original conclusions that '… recovery from CFS is possible, and that CBT and GET are the therapies most likely to lead to recovery’ is an important, reasonable, and hopeful message for both clinicians and patients."
- 2016, Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome
- 2016, A UK based review of recommendations regarding the management of chronic fatigue syndrome
- 2004, Immunological Changes After Both Exercise and Activity in Chronic Fatigue Syndrome: A Pilot Study
"Abstract - Background: The chronic fatigue syndrome (CFS) is characterized by post-exertional malaise and fatigue. We designed this pilot study to explore whether the illness was associated with alterations in immunological markers following exercise. Methods: We measured immunological markers before and up to three days after either a sub-maximal or maximal bicycle exercise test. We studied nine patients with CFS and nine age-and sex-matched healthy but sedentary controls. We also studied the same patients with CFS at home after a night's sleep and then after traveling to the study center. Results: There were no significant differences in any of the cell markers after a sub-maximal exercise test compared to a maximal test. However, we found elevated concentrations of plasma transforming growth factor beta (TGF-ß), even before exercise, in subjects with CFS (median (IQR) of 904 (182-1072) pg/ml) versus controls (median (IQR) of 50 (45-68) pg/ml) (P < .001). Traveling from home to the hospital significantly elevated TGF-ß concentrations from a resting median (IQR) concentration of 1161 (130-1246) pg/ml to a median (IQR) concentration of 1364 (1155-1768) pg/ml (P < .02). There was also a sustained increase in plasma tumor necrosis factor alpha (TNF-cc) after exercise in CFS patients, but not in controls (P = .004 for the area under the curve), although traveling had no such effect. CD3, CD4 and HLA DR-expressing lymphocyte counts were lower in CFS patients, but exercise had the same effect in both groups, causing an immediate increase in circulating cell numbers that lasted less than three hours. Conclusions: These results suggest that the relationship between physical activity and both pro-inflammatory and anti-inflammatory cytokines merits further investigation in patients with CFS. The results also emphasize the importance of defining a truly resting baseline condition in such studies."
- 2003, Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution
Talks & interviews
- What is CFS, and what is ME? Bergen, October 20 2009
- What causes CFS/ME, and does this determine treatment? Bergen, October 20 2009
- Treatments for chronic fatigue syndrome. Bergen, 20 October 2009
- Royal Society of Medicine, 28 April 2008 (Transcript)
- BBC You & Yours transcript, 5 November 2007
Online presence/List of Publications
Peter Denton White is a director and has 2 total appointments. He is a director of OneHealth (Company number 04364122) from 2002 to 2010. The memorandum of association states that the purpose is to promote the biopsychosocial model of illness. He is also a director of Added Value Advisory Services (Company number 03764154) from 1999 to date.
None of these have been disclosed in his research work and publications.
- 2016, 'Proof Positive (Revisited)' (14 Sep 2016)
- 2016, ‘It was like being buried alive’: battle to recover from chronic fatigue syndrome
- 2015, Institute of Medicine report - Review (8 December 2015, see also Institute of Medicine report)
- Williams, Margaret (14 Sep 2016), Proof Positive (revisited) (PDF)
- White, Peter D (2011), "Managing claims for chronic fatigue the active way", Swiss Re (insurance), archived from the original on 25 Jul 2013
- Tuller, David (17 Nov 2015), "Trial By Error, Continued: PACE Team's Work for Insurance Companies Is "Not Related" to PACE. Really?", Virology Blog
- Sharpe, M; Chalder, T; Johnson, AL; Goldsmith; White, PD (2017), "Response to: Do more people recover from chronic fatigue syndrome with cognitive behaviour therapy or graded exercise therapy than with other treatments?", Fatigue: Biomedicine, Health & Behavior, 5 (1), doi:10.1080/21641846.2017.1288629
- P. D. White, K. E. Nye, A. J. Pinching, T. M. Yap, N. Power, V. Vleck, D. J. Bentley, J. M. Thomas, M. Buckland & J. M. Parkin. (2004). Immunological Changes After Both Exercise and Activity in Chronic Fatigue Syndrome: A Pilot Study. Journal of Chronic Fatigue Syndrome, Vol. 12, Iss. 2, pp. 51-66. http://dx.doi.org/10.1300/J092v12n02_06
- Reeves, W. C.; Lloyd, A.; Vernon, S. D.; Klimas, N.; Jason, L. A.; Bleijenberg, G.; Evengard, B.; White, P. D.; Nisenbaum, R.; Unger, E. (2003), "Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution", BMC Health Services Research, 3 (25), doi:10.1186/1472-6963-3-25