Alan Gurwitt

Alan R. Gurwitt, MD, retired adult and child psychiatrist from Massachusetts, USA, and Distinguished Fellow of the American Psychiatric Association. Formerly an Associate Clinical Professor, Yale Child Study Center and University of Connecticut School of Medicine.

He has served as the Psychiatric Association President of the Massachusetts CFIDS/ME & FM Association and on the Guidelines Committee of the International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

Education

 * M.D., Yale School of Medicine

2017 Pediatric Primer
Dr. Gurwitt was one of the authors of the 2017 Pediatric Primer published in Frontiers in Pediatrics.
 * Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer (OPEN ACCESS/FULL TEXT). Authors: Peter Rowe, Rosemary A. Underhill, Kenneth J. Friedman, Alan Gurwitt, Marvin S. Medow, Malcolm S. Schwartz, Nigel Speight, Julian M. Stewart, Rosamund Vallings and Katherine S. Rowe Abstract:Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents. ME/CFS is characterized by overwhelming fatigue with a substantial loss of physical and mental stamina. Cardinal features are malaise and a worsening of symptoms following minimal physical or mental exertion. These post-exertional symptoms can persist for hours, days, or weeks and are not relieved by rest or sleep. Other symptoms include cognitive problems, unrefreshing or disturbed sleep, generalized or localized pain, lightheadedness, and additional symptoms in multiple organ systems. While some young patients can attend school, on a full or part-time basis, many others are wheelchair dependent, housebound, or bedbound. Prevalence estimates for pediatric ME/CFS vary from 0.1 to 0.5%. Because there is no diagnostic test for ME/CFS, diagnosis is purely clinical, based on the history and the exclusion of other fatiguing illnesses by physical examination and medical testing. Co-existing medical conditions including orthostatic intolerance (OI) are common. Successful management is based on determining the optimum balance of rest and activity to help prevent post-exertional symptom worsening. Medications are helpful to treat pain, insomnia, OI and other symptoms. The published literature on ME/CFS and specifically that describing the diagnosis and management of pediatric ME/CFS is very limited. Where published studies are lacking, recommendations are based on the clinical observations and practices of the authors.

Writings

 * 26 June 2015, Health Rising blog by Dr. Gurwitt - No Signs of Life at the Big Health Agencies "Excerpt: 'In summary, nothing will change until we change. We must not wait for the federal health agencies nor should we go it alone. We must take a series of steps. One step is to create a multi-pronged coordinated and comprehensive effort to recruit congressional support. We must also build a strong national coalition of patients, advocates, and professionals. We have many wonderfully informed, thoughtful, and active patient advocates among us but our failure to coalesce has created a major obstacle. The challenges are great so our efforts must be greatly smarter, focused, and more effective. Failure to change our efforts and directions will doom us to remaining stuck. We should utilize our own capacities and wait no more.'"


 * 2014, Dr. Gurwitt was a member of the Primer writing committee for the 2014 edition of [[ME/CFS: A Primer For Clinical Practitioners]] sponsored by the International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Dr.Fred Friedberg chaired the committee. Other Primer writing committee members include: Rosemary Underhill, MB, BS; Lucinda Bateman, MD; Alison Bested, MD; Todd Davenport, DPT; Kenneth Friedman, PhD; Alan Gurwitt, MD; Leonard Jason, PhD; Charles Lapp, MD; Staci Stevens, MA; and Rosamund Vallings, MB, BS. Anthony Komaroff, MD wrote the foreword to the Primer.


 * June 2012, Dr. Alan Gurwitt's letter to DSM-V Committee of the APA "Excerpt: 'The bottom line is that CFS and fibromyalgia are not psychological illnesses. It is then essential that the American Psychiatric Association vigorously help educate graduate and resident psychiatrists on this essential truth. While the wording and criteria for 'Complex Somatic Symptom Disorder' will matter so as to avoid confusing chronic fatigue syndrome and fibromyalgia with a somatoform disorder it will be new understanding of the biological nature, proper diagnostic techniques, and appropriate treatments of these illnesses that will matter most.'"


 * 2006, "A Pediatric Case Definition for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome""'Summary: For a diagnosis of chronic fatigue syndrome (CFS), most researchers use criteria that were developed by Fukuda et al. (1994), with modifications suggested by Reeves et al. (2003). However, this case definition was established for adults rather than children. A Canadian Case Definition (ME/CFS; Myalgic Encephalomyelitis/CFS) has recently been developed, with more specific inclusion criteria (Carruthers et al., 2003). Again, the primary aim of this case definition is to diagnose adult CFS. A significant problem in the literature is the lack of both a pediatric definition of ME/CFS and a reliable instrument to assess it. These deficiencies can lead to criterion variance problems resulting in studies labeling children with a wide variety of symptoms as having ME/CFS. Subsequently, comparisons between articles become more difficult, decreasing the possibility of conducting a meta-analysis. This article presents recommendations developed by the International Association of Chronic Fatigue Syndrome Pediatric Case Definition Working group for a ME/CFS pediatric case definition. It is hoped that this pediatric case definition will lead to more appropriate identification of children and adolescents with ME/CFS.'"

CFSAC

 * Oct 2012, Presentation to the Chronic Fatigue Advisory Committee about the Massachusetts CFIDS/ME & FM Association including past and proposed projects.

Talks and interviews

 * 12 Apr 2017, Episode 87 - ME/CFS Diagnosis, children with ME, the medical community with Alan Gurwitt, M.D.