Simon Wessely

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

Sir Simon Charles Wessely M.A., M.Sc., M.D., F.R.C.P., M.R.C.Psych., (born 23 December 1956) is a British Professor of Psychiatry at King’s College London and a Consultant Liaison Psychiatrist at King’s College and the Maudsley Hospitals.[1] He became director of the Chronic Fatigue Research Unit at King's College London in 1994[2] and has since been one of the most influential researchers in the field of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).[3] Wessely helped develop the cognitive behavioral model (CBM) of chronic fatigue syndrome, a rehabilitation-based model in which unhelpful thoughts and avoidance behavior are believed to perpetuate the symptoms of ME/CFS.[4][5] Wessely suspects ME/CFS to be a "general disorder of perception."[6] Although Wessely has received many honours for his work and services,[2] his research is considered controversial[7] and has been criticized by ME/CFS expert clinicians, researchers and patients.[8][9][10][11][12]

Biography

Simon Wessely is the son of Rudolf Wessely, one of the Jewish children who managed to escape the Nazi regime through the help of Nicholas Winton.[13] He studied medicine at the universities of Cambridge and Oxford, epidemiology at the London School of Hygiene and psychiatry at the Maudsely Hospital in 1984.[14] While working at the Maudsely, Wessely developed an interest into medically unexplained symptoms and chronic fatigue syndrome. He became Director of the Chronic Fatigue Research Unit at King's College London in 1994 and of the Gulf War Illness Research Unit in 1996.[2]

Wessely has published approximately 600 papers[15] and written books about chronic fatigue syndrome, the history of military psychiatry and clinical trials in psychiatry.[16] From 2014 to 2017, Wessely was the elected president of the Royal College of Psychiatrists. He is married to Clare Gerada[17] who was chairperson of the Council of the Royal College of General Practitioners from 2010 to 2013.[18] Wessely has been honoured by the Advisory Committee on Clinical Excellence Awards[2]; the Royal College of Physicians[2]; the American Psychiatric Association[2]; the Association of British Neurologists[2] and more recently by Oxford University.[1] In 2011 he was awarded the John Maddox prize for standing up for science.[19] Wessely was knighted in 2012[20] and became the World's first Regius Professor in Psychiatry in 2017.[21] Wessely considers his greatest achievement to be helping to show that chronic fatigue syndrome can be treated.[2]

Research into ME/CFS

Chalder Fatigue Scale

Working at the Maudsley Hosptial in the 1980s, Wessely developed an interest into patients with unexplained chronic fatigue.[22] According to Wessely, these patients were then frequently sent to neurologists. The prevailing idea was that something might be wrong with their muscles, although tests usually came back normal.[22] One of Wessely's first studies reported that these chronically fatigued patients resembled patients suffering from an affective disorder (eg depression) rather than those with a neuromuscular illness.[23] It was during this study that Wessely and colleagues developed the Chalder Fatigue Scale,[24] a short questionnaire that is frequently used in research into fatigue and has been translated into multiple languages.

CFS diagnostic criteria

In the late 1980s Wessely called for the adoption of operational criteria for CFS.[25] He criticized the Holmes criteria for having "overzealous physical and psychological exclusions"[26] and requiring too many symptoms. Wessely subsequently became one of the authors of the British research criteria for CFS, known as the Oxford criteria,[27] and one of the members of the International Chronic Fatigue Syndrome Study Group that helped formulate the Fukuda criteria.[28] The Oxford criteria are widely regarded as the "least restrictive", possibly diagnosing patients with idiopathic chronic fatigue or fatigue from other conditions as CFS.[29][30] The Fukuda criteria later became the most commonly used criteria for both the diagnosis and research of CFS.[31]

Neurasthenia, depression and burnout

Wessely has argued that chronic fatigue syndrome (CFS) has many similarities to atypical depression[23] and burnout[32], which are also characterized by fatigue symptoms. According to Wessely, “the feeling that CFS is but a synonym for better known psychiatric disorders refuses to go away, because it is partly true.”[33] The main difference, according to Wessely, is believed to be one of attribution, as CFS patients often think their illness is caused by an external factor such as a virus. In his publications Wessely argued that external attributions lessen guilt and avoid blame, but increase the risk of long-term disability.[34]

In an article titled “Old wine in new bottles”[35] he highlights the resemblances with neurasthenia, a fatigue diagnosis that was popular at the turn of the 20th century but has since fallen out of use in most of the Western world. According to Wessely both neurasthenia and CFS should be seen as “culturally sanctioned expressions of distress”[35] for those uncomfortable with the psychological aspects of illness. Within the CFS label, ill health can be blamed on environmental threats and unwelcome features of modern life. Wessely reasoned that CFS is a “mirror of society”,[36] “not simply an illness but a cultural phenomenon and metaphor of our times.”[36]

According to Wessely, “some of the modern impetus to 'allow' a specific chronic fatigue syndrome arises from the various compensation and social insurance schemes operating in developed countries.”[37] He has argued that the CFS label makes it easier to allow reimbursement or compensation for fatigue, pain and misery, claiming that “If the chronic fatigue syndrome did not exist, our current medical and social care systems might force us to invent it.”[37]

A disorder of the perception of effort

In several publications, Wessely wrote that he suspects CFS to be a general disorder of perception, in particular the peception of effort.[38][6][37][39][40]:168 In an article in the Encyclopedia of Stress, for example he wrote:

"One theme that emerges from the literature of all the fatigue syndromes is the possibility of a general disorder of perception, perhaps of both symptoms and disability. At the heart of this misperception lies the sense of effort. CFS patients clearly experience increased effort in everyday physical and mental tasks.”[6] 

Epidemiology of CFS

With his training in clinical epidemiology at the London School of Hygiene[14], Wessely was able to perform one of the first large epidemiological studies of CFS in the United Kingdom. His study in primary care indicated no socioeconomic gradient for CFS, suggesting the excess of upper social classes in specialist clinics is due to selection bias.[41] The prevalence of CFS in the 18- to 45-year age group was estimated at 2.6% using the CDC's Fukuda criteria[41]:1452, more than ten times as large as what later studies would report.[42][43] The high prevalence could be due to a limited amount of laboratory screening tests, which was restricted due to cost.[44] Wessely also worked on epidemiologic studies to determine the prevalence of CFS in children[45][46], the prevalence of CFS in Brazil[47] and the relationship between fatigue and mental health problems.[48][49] The same study found the prevalence of idiopathic chronic fatigue (ICF) was 9%, and patients with ICF were less severely affected then those with CFS.[41]:1452. Using data from the British birth cohort, Wessely reported that a psychiatric disorder increased the chance of a self-reported diagnosis of CFS/ME later in life.[50] With data from the Clinical Record Interactive Search (CRIS), Wessely and colleagues reported a more than sixfold increase in suicide-related mortality in patients with CFS, however this was calculated from only five deaths by suicide.[51]

Cognitive behavioral therapy

In the late 1980s Wessely and colleagues developed the cognitive behavioral model (CBM) of chronic fatigue syndrome, a rehabilitation-based model in which unhelpful thoughts and avoidance behavior are believed to perpetuate the symptoms of ME/CFS.[4][5] This model forms the rationale for the use of cognitive behavioral therapy (CBT), one of the most frequently prescribed treatments for CFS, and graded exercise therapy (GET). With CBT, CFS patients are encouraged to take on a pragmatic approach, to disregard what might have caused their illness and focus on the behavioral factors that are posited to perpetuate their symptoms.[5] Patients are encouraged to no longer view the syndrome as a chronic and incurable disease and are told they can improve but that they themselves have a significant role to play in this.[52] With CBT thoughts such as the belief that symptom flares indicate damage or an underlying disease process are regarded as "catastrophizing" or unhelpful beliefs, and these are challenged.[53] Bodywatching, also known as symptom focusing, a heightened awareness to bodily sensations, is explained to be counterproductive.[6] The main emphasis of CBT however is on reversing "maladaptive avoidance behavior". The aim is to tackle “the handicapping, stimulus-driven cycle of CFS, in which symptoms are always a signal to rest, and to replace previous sensitization by tolerance.”[54]  With CBT, patients are instructed to increase their activity level time-contingently and to no longer respond to symptom increases by resting.[53] This usually involves a gradual increase in exercise such as walking or swimming.[5]

In 1997, Wessely, Deale and colleagues conducted a randomized controlled trial with a five year follow up which indicated that CBT is more effective in relieving CFS symptoms than relaxation therapy,[55] with improvements sustained over the long term, although they did not consider it a ‟cure”.[56] A number of other CBT trials for chronic fatigue syndrome have reported positive findings,[57] although some have reported no overall effect.[58] CBT became recommended as an evidence-based treatment for CFS by several health authorities, followed by the CDC and the UK's National Health Service.[59] More recently the effectiveness of CBT in CFS has been criticized for relying on subjective outcomes in unblinded studies.[60][61][62] Objective outcomes which are less prone to biases show no improvements following CBT.[62]  In many patient surveys, respondents indicated to have been harmed by the graded activity approach in CBT.[63][64][65]  Wessely however has defended the methodogical weaknesses of CBT trials, including the PACE trial,[66] and emphasized that there is “no particular reason why graded exercise carried out under appropriate professional supervision should be harmful.”[67]

PACE trial

Simon Wessely was involved in the PACE trial, a large but controversial study that investigated the effectiveness of CBT, GET and adaptive pacing therapy (APT) in a sample of more than 600 CFS patients. Wessely was center manager for one of the PACE trial centers, a member of the PACE Trial Management Group, provided specialist medical care (SMC) to PACE trial patients and "advice about design and execution" of the trial, and according to the main PACE trial publication, commented on "an early draft" of the publication.[68] Wessely's earlier contributions to CFS research were highly influential in the setup of the PACE trial; it used the Chalder Fatigue Scale as one of the primary questionnaires to assess impairment and recovery, the Oxford criteria for CFS to select patients, while the cognitive behavioral model was the underlying theory described in the therapist and patient manuals.[68]

The PACE trial has been criticized for multiple methodological faults.[69][70] An open letter signed by more than 100 prominent ME/CFS experts including researchers and clinicians has called for “an independent re-analysis of the individual-level trial data, with appropriate sensitivity analyses."[71] Wessely however has repeatedly defended the PACE trial, calling it a "thing of beauty."[72] In a blog post in which he described the PACE trial as a "landmark in behavioral complex intervention studies",[66] he was criticized for failing to disclose his full role in the trial.[73] Wessely then responded claiming he was not aware of being a center leader.[74]

Science Media Centre

Wessely is on the board of trustees of the Science Media Centre[75] (Company number 07560997), which has defended the results of the PACE trial to the media.[76]

Biomedical research

Wessely has conducted a multitude of biomedical studies into CFS, often putting popular ideas to the test. His research team reported that ordinary infections do not increase the risk of CFS[77], although there was an increased prevalence following viral meningitis and other more serious infections.[78] Wessely and colleagues also demonstrated that there was no connection between the xenotropic murine leukemia virus-related virus (XMRV) and CFS.[79][80]

Wessely's research team has studied type 2 cytokine-producing cells[81], human leukocyte antigen (HLA)-genes[82], antinuclear autoantibodies (ANA)[83], and VP-1 antigens[84] suggestive of enteroviral infection in patients with CFS. His research team looked into growth hormone[85] and cortisol abnormalities[86][87][88][89][90][91] in patients with CFS and conducted a randomized controlled trial of hydrocortisone treatment, which indicated reduced fatigue levels in the short term.[92] Wessely reported on reduced vitamin B-status[93], an increased prevalence of coeliac disease[94] and autonomic dysfunction[95] in patients with CFS compared to controls.

His research team reported that, contrary to popular thought, there is no indication of hyperventilation[96] in patients with CFS and that the stereotype of CFS sufferers as perfectionists with negative attitudes toward psychiatry is not supported by scientific investigation.[97] Contrary to his own expectation, Wessely demonstrated that there is significant correlation between low blood pressure and fatigue[98] and that CFS patients have often reduced their alcohol consumption[99], in contrast to patients with affective disorders.

Medically unexplained symptoms (MUS)

In an influential 1999 article, Wessely and colleagues stated that somatic syndromes, which in their view included CFS, are an “artefact of medical specialisation.”[100] They argued that there’s a large population of patients with multiple medically unexplained physical symptoms (MUS or MUPS) and that it’s mostly the specialist they see that determines their diagnosis. When seen in gastroenterology patients might be diagnosed with irritable bowel syndrome, in rheumatology with fibromyalgia, in cardiology with atypical chest pain, in neurology with tension headache and in an infectious diseases clinic with chronic (postviral) fatigue syndrome.[100] Wessely and colleagues stated that there’s a large overlap in case definitions of these illnesses and that patients often meet multiple diagnostic criteria.[101] They have argued that these symptom-based criteria do not “cleave nature at the joints”[37] and these should best be viewed together as one functional somatic syndrome.[102] In support of this view, Wessely and colleagues argued that these diagnoses have multiple commonalities such as a predominance of women, a history of childhood trauma or abuse, comorbid emotional disorders and a responsiveness to antidepressants and psychological interventions,[100] although other research has found these were unrelated factors or had no significant effect on CFS patients.[103][104][105][106]

Wessely’s research reported that MUS are common and account for approximately half of patients referred to a variety of specialties.[107] Little evidence was found for the somatization concept. Patients who report a greater number of physical symptoms are also more likely to report symptoms of anxiety and depression, indicating that the former are not associated with a denial of psychological distress.[108] Wessely en colleagues did report that patients with MUS often had a parent in bad health, a relationship that “may reflect a learned process whereby illness experience leads to symptom monitoring.”[109] According to Wessely, characterizing MUS as purely psychological complaints is likely to be counterproductive. Exposure to such attitudes “may paradoxically reinforce their determination to maintain the sick role, since to do otherwise would confirm the doctor’s own view – that it was ‘all in the mind’ after all.”[110] Instead Wessely advises a holistic approach using the biopsychosocial model.

Other researchers have questioned the use of a broad MUS-classification as it might hamper research into the underlying pathology of poorly understood conditions.[101][111][112]

Other Research

Gulf war syndrome

Wessely is a consultant advisor in psychiatry to the British Army[113] and has done extensive research into the health of soldiers deployed in war zones. In an influential 1999 study, published in the Lancet, Wessely performed the UK’s first systematic epidemiological study on veterans suffering from Gulf War Syndrome.[114] Wessely’s team compared 4246 randomly selected British Gulf War veterans with servicemen deployed to the 1990s Bosnia conflict and a group of soldiers who served during the Gulf War but were not deployed there. The study showed that Gulf war veterans were more likely to report each one of the dozens of symptoms that were assessed.[114] “Whatever the symptom, the rate was at least twice as high in the Gulf cohort as in either the non- deployed cohort or the Bosnia cohort.”[115] According to Wessely this indicated that there was a Gulf War health on soldiers deployed there but no evidence of a Gulf War syndrome, a unique constellation of signs or symptoms. Instead the symptoms reported show a large overlap with other medically unexplained complaints such as chronic fatigue syndrome in civilians.[116][117]

Wessely has pointed out that unexplained illnesses have repeatedly been reported in soldiers deployed to combat and that these are often related to the particular nature of the conflict.[118][115] Soldier’s heart for example arose out of concern that the straps securing the backpacks of soldiers in the American Civil War were compressing the region around the heart while shellshock took its name from the presumed effects of concussion caused by bombardments.[115] Similarly Wessely has argued that the Gulf War Syndrome arose out of concerns about the use of vaccinations, chemical agents and other biological weapons.[119][120][115] According to Wessely biological factors such as exposure to depleted uranium, poorly explains the ill health of Gulf War veterans.[121][122] Self-reported exposure to multiple vaccinations initially showed a relationship with poor health[123], but there was no association when vaccinations were recorded objectively from medical records.[124] Wessely’s research also indicated that the Gulf War health effect could not be explained by stress or psychological disorders[125] as there was no such health effect with soldiers deployed to the Iraq war[126][127], which was a longer, harder, and more dangerous campaign.[125]

Wessely has argued that the story of Gulf War ill health began with some soldiers reporting symptoms but that these were amplified by concerns towards possible exposure to Saddam Hussein chemical agents.[115][119] Wessely argues that the symptoms and concerns were taken up by the media[121] which it shaped into a particular syndrome. According to Wessely “the transmission of rumour was a significant part of the very construction of the condition itself.”[128]

Resiliance

Wessely has written about many other subjects including peer-review[129], the effectiveness of antidepressants[130], the rise of counselling[131] and the stigma attached to psychiatric illnesses.[132] One common theme in his writing is resilience. Wessely emphasizes that adversity is part of human experience, that not everyone exposed to adversity becomes a victim and that “we should resist the temptation to redefine our identities solely in terms of what has been done to us.”[131] In a provocative paper titled “going to war does not have to hurt”[133] Wessely argued that deployment to armed conflict does not necessarily result in ill health, claiming that soldiers deployed to the Iraq war do not have an increase in psychological symptoms. Wessely has been critical of the concept of post-traumatic stress disorder (PTSD) because it assumes that the cause of the disorder is known. According to Wessely “the view that the determinants of PTSD are to be found solely in the nature of the stressor cannot be sustained.”[134] Wessely has also criticized the use of psychological debriefing[135][136] and screening for depression[137][132], arguing these techniques are not effective and that resources should better devoted to patients with known psychiatric illness currently underserved.[132]

Controversy

Emphasis on psychosocial factors

While Wessely’s work has been influential, it is also considered to be controversial.[8] Patients and researchers have argued that he overemphasizes psychological, social and cultural elements and downplays the organic factors in poorly understood illnesses.[8][9][10] Wessely for example has argued that illnesses such as multiple chemical sensitivities[138] and electromagnetic hypersensitivity[139] reflect psychological disturbances and often mask psychiatric illnesses. In regards to symptoms attributed to allergies, Wessely wrote that some patients have developed “a lifestyle around their illness, with their own journals, clinics, and self help groups."[140]

Wessely suggested that psychological factors were responsible for ill health reported after contamination of the water supply with aluminium sulphate in Camelford, England in 1988. Wessely wrote that “the most likely explanation of the Camelford findings is that the perception of normal and benign somatic symptoms (physical or mental) by both subjects and health professionals was heightened and subsequently attributed to an external, physical cause, such as poisoning.”[141] McMillan et al (1993) disagreed, and reported evidence of significant physical harm in some who drank the contaminated water. [142]

The UK government formally apologized in 2013, 25 years later, to those whose health was affected by the water supply contamination. Calls for a public inquiry have continued.[143][144] Similarly Wessely has argued that ill health reported following the collapse of the Twin Towers on 9/11, is a “consequence of an ideology that tells us that our physical environment is responsible for most of our bodily discomforts and ills.”[145]

World Health Organization classification

Professor Malcolm Hooper[146] and Margaret Williams have criticized Wessely for including ME/CFS In the first edition of the “Guide to Mental Health in Primary Care” issued by the Institute of Psychiatry (IOP). The Guide, available to all GPs in the UK, was produced by the UK WHO Collaborating Centre at the IOP and bore the WHO logo.[146] The matter was discussed in the UK Parliament on 22 January 2004, namely whether Professor Wessely had used the WHO logo to give credence to his own view of ME as a mental illness.[147] The WHO classifies ME, CFS and Post-viral fatigue syndrome (PVFS) under code G93.3 in Chapter VI Diseases of the nervous system of the International Classification of Diseases version 10 (ICD-10), specifically excludes ME/CFS/PVFS from the neurasthenia diagnosis,[148] and has repeatedly made clear that it “is not permitted for the same condition to be classified to more than one rubric”[149] and that ME/CFS/PVFS can only be classified under neurological disease.[148]

Iatrogenesis and ME

Wessely has criticized doctors who favor a biomedical approach to poorly understood illnesses. According to Wessely “there is a considerable degree of iatrogenesis in the rise of these conditions.”[150] Wessely has argued that diagnosing patients with myalgic encephalomyelitis (ME) as if it was an incurable and chronic condition can act as a self-fulfilling prophecy.[36][40][40] He warned that campaigning for more awareness of ME in adolescents might have increased the incidence of young people with such presentations.[40]:304[151][33] In contrast to CFS, Wessely has argued that ME is not an accepted medical diagnosis with established diagnostic criteria and that this diagnosis should therefore be interpreted as a belief system - “a person has ME when they say they do.”[152][153] According to Wessely and colleagues “understanding of the postviral fatigue syndrome has been hindered by doctors who suffer from the condition also researching it.”[4]

Death threats and accusations of abuse

In 2011, Professor Wessely stated that he had been subject to abuse, threats of violence and even death threats by "activists" including patients who objected to his research.[154][155][156][157][158][159][160] In one interview he that stated research into CFS/ME made him feel unsafe, and he has moved his research to studies of Gulf war syndrome and other conditions linked to war; "I now go to Iraq and Afghanistan, where I feel a lot safer."[161] Wessely believes ME activists dislike his research because it focuses on the psychological elements of chronic fatigue syndrome.[155] He has claimed that “it’s safer to insult the Prophet Mohammed than to contradict the armed wing of the ME brigade.”[155] In 2012 Wessely was awarded the John Maddox Prize for Standing up for Science for the way he dealt with intimidation and harassment during his research of ME/CFS[19], a decision that was contested.[8]

Evidence of abuse and threats

ME advocate and former barrister Valerie Eliot-Smith stated that in her opinion such stories were "massively over-hyped" but also that she believed Wessely had been the subject to "credible threats" and abuse, referring to one video she saw that was created around 2009-2011, i.e., before the PACE trial data court case.[162] The video was briefly posted on the internet but is no longer publicly available, and other reports of threats are very difficult to verify.[162]In 2012, King's College London, Sir Wessely's employer, responded to a Freedom of Information Act (FOIA) request stating it held information on threats to Simon Wessely from "a range of individuals".[163] The college refused to confirm or deny whether it had a record of Wessely taking private legal advice about the alleged intimidation or reporting any to the police, but the response implied that legal advice had not been provided by King's College London.[163] In 2017, another FOIA asked if King's had a record of any "substantiated claims of harassment of allegations of threats" to staff. King's refused to disclose this, claiming an exemption from FOIA disclosure.[164]

Anti-psychiatry stigma

Wessely has argued that much of the passionate criticism of his work on chronic fatigue syndrome is driven by anti-psychiatry sentiments, claiming that “at the heart of the ME/ CFIDS movement is the rejection of any form of psychological causation or treatment. Being referred to a psychiatrist is being blackballed, being on trial or imprisoned for a crime I didn’t do.”[40][165] According to Wessely, some of the patients who campaign for ME and against the biopsychosocial model of CFS, have an obsession about psychiatry. “With these people, it isn’t that they don’t want to get better but if the price is recognising the psychiatric basis of the condition, they’d rather not get better.”[166] Similarly, Wessely has argued that “the drive to find a somatic biomarker for chronic fatigue syndrome is driven not so much by a dispassionate thirst for knowledge but more by an overwhelming desire to get rid of the psychiatrists.”[167] As president of the UK's Royal College of Psychiatrists, Wessely launched the Anti-BASH (#BantheBash) campaign to stop stigma attached to psychiatry.[132] In the context of CFS, Wessely has argued that "articles in the press concentrate on a simple medical model of illness reinforcing the stigma of psychological illness and dissatisfaction with traditional medical authority."[168]

Ean P.

Wessely was involved in the controversial management of a child with severe ME named Ean P. who was taken away from his parents to follow rehabilitative treatments.[169] The parents of the child claimed that the medical carers of Ean had engaged in professional misconduct, an allegation that was not fully confirmed by subsequent enquiries.[170] As a psychiatrist who investigated Ean, Wessely had argued that he did not have a primary organic illness but a psychological illness that required intensive rehabilitation.[171]

Page vs. Smith

Wessely was also consulted as an expert in a notorious legal case, Page vs Smith, where a patient reported a relapse of a chronic fatigue syndrome after a car crash.[172] Wessely argued that the patients relapsed not because of any neurological or immunological process but because of his vulnerability to psychiatric injury, as the person had a history of previous psychological disorder.[173]

Gremlins at the BMJ

In the year 2000 one of Wessely’s papers in the BMJ was criticized by Martin Bland, professor of medical statistics, for having multiple statistical flaws.[174] Wessely admitted the mistakes but said his original version did have the correct analysis and figures and that the errors seem to have happened when the manuscript was being published by the journal. Wessely’s account was confirmed by Norwegian researcher Jon Håvard Loge who had received a copy of the original version that did not have the statistical mistakes.[175] Wessely joked that “somewhere between the analysis and the printed copy we have been attacked by gremlins.”[176] Editor of the BMJ Richard Smith however pointed out that the mistake could also have happened when one of the reviewers asked for a change in presentation of the figures, and the authors not making this change correctly.[177]

Research studies related to ME/CFS

See also
XMRV.

Books

Talks, interviews, and newspaper articles

Online presence

Criticism

Articles

Quotes

Quote Source Date
"I will argue that ME is simply a belief, the belief that one has an illness called ME" Simon Wessely[193][194] 1994
"Beliefs are consequently probable illness-maintaining factors and targets for therapeutic intervention" Simon Wessely, Michael Sharpe, Trudie Chalder, L Palmer[195] 1997
"The clinical problem we address is the assessment and management of the patient with a belief that he/she has an illness such as CFS, CFIDS or ME..." Simon Wessely, Michael Sharpe, Trudie Chalder, L Palmer[195] 1997
"In a previous era, spirits and demons oppressed us. Although they have been replaced by our contemporary concern about invisible viruses, chemicals and toxins, the mechanisms of contagious fear remain the same... To the majority of observers, including most professionals, these symptoms are indeed all in the mind" Simon Wessely[196] 2000
"Like it or not, CFS is not simply an illness, but a cultural phenomenon and metaphor of our times" Simon Wessely, MJ Huibers[197] 2006
"Blaming symptoms on a viral infection conveys certain advantages, irrespective of its validity.... It is also beneficial to self‐esteem by protecting the individual from guilt and blame" Simon Wessely, Trudie Chalder[198] 1991

See also

References

  1. ↑ 1.0 1.1 "Honorary degree recipients for 2019 announced". University of Oxford. Retrieved July 15, 2019.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Dosani, Sabina (September 2012). "e-Interview". The Psychiatrist. 36 (9): ibc–ibc. doi:10.1192/pb.bp.112.040436. ISSN 1758-3209.
  3. ↑ "The 20 Years Ago Today Series III: the Most Influential Researchers of the Last 20 Years". Phoenix Rising ME / CFS Forums. Retrieved July 15, 2019.
  4. ↑ 4.0 4.1 4.2 David, Anthony S; Wessely, Simon; Pelosi, Anthony J (March 5, 1988). "Postviral fatigue syndrome: time for a new approach". British Medical Journal (Clinical research ed.). 296 (6623): 696–699. ISSN 0267-0623. PMC 2545306. PMID 3128374.
  5. ↑ 5.0 5.1 5.2 5.3 Wessely, Simon; David, Anthony; Butler, S; Chalder, Trudie (January 1989). "Management of chronic (post-viral) fatigue syndrome". The Journal of the Royal College of General Practitioners. 39 (318): 26–29. ISSN 0035-8797. PMC 1711569. PMID 2553945.
  6. ↑ 6.0 6.1 6.2 6.3 Wessely, Simon; Cleare, Anthony J (2000). "Chronic fatigue syndrome". In Fink, George (ed.). Encyclopedia of Stress. Academic Press. pp. 460–466. ISBN 9780080569772.
  7. ↑ IloveCBt (December 14, 2011), Dr. Ian Gibson on BBC radio: Prof Simon Wessely has been blocking proper research into ME for years, retrieved July 17, 2019
  8. ↑ 8.0 8.1 8.2 8.3 "ME: bitterest row yet in a long saga". The Independent. November 25, 2012. Retrieved July 15, 2019.
  9. ↑ 9.0 9.1 Maes, Michael; Twisk, Frank N. M. (June 15, 2010). "Chronic fatigue syndrome: Harvey and Wessely's (bio)psychosocial model versus a bio(psychosocial) model based on inflammatory and oxidative and nitrosative stress pathways". BMC medicine. 8: 35. doi:10.1186/1741-7015-8-35. ISSN 1741-7015. PMC 2901228. PMID 20550693.
  10. ↑ 10.0 10.1 "Invest in ME - Margaret Williams - Wesselys Ways: Rhetoric or reason?". Invest in ME Research. Retrieved July 15, 2019.
  11. ↑ One Click Group. "ME sufferers have found enemy in Wessely". whale.to. Retrieved July 17, 2019.
  12. ↑ Correspondance between Countess of Mar and Simon Wessely, 2012.
  13. ↑ Wessely, Simon (December 30, 2013). "Rudolph Wessely obituary". The Guardian. ISSN 0261-3077. Retrieved July 15, 2019.
  14. ↑ 14.0 14.1 "About | Simon Wessely". simonwessely.com. Retrieved July 15, 2019.
  15. ↑ pubmeddev. "Simon Wessely - search PubMed - NCBI". ncbi.nlm.nih.gov. Retrieved July 15, 2019.
  16. ↑ "Amazon.co.uk: Simon Wessely: Books". amazon.co.uk. Retrieved July 15, 2019.
  17. ↑ Gerada, Clare (October 16, 2013). "Clare Gerada: Best move was "getting into drugs"". The BMJ. p. f6192. doi:10.1136/bmj.f6192. ISSN 1756-1833. PMID 24133128.
  18. ↑ "Leading GP to co-chair new body advising on delivery of long-term plan | GPonline". gponline.com. Retrieved July 15, 2019.
  19. ↑ 19.0 19.1 "2012 John Maddox Prize – Sense about Science". web.archive.org. September 23, 2018. Retrieved July 15, 2019.
  20. ↑ "Knighthood for Professor Simon Wessely | BBC News | 29 December 2012". Retrieved July 15, 2019.
  21. ↑ "King's College London - World's first Regius Professor in Psychiatry - Professor Sir Simon Wessely". kcl.ac.uk. Retrieved July 15, 2019.
  22. ↑ 22.0 22.1 Wessely, Simon C. (January 2012). "Impact Commentaries. The nature of fatigue: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders". Journal of Neurology, Neurosurgery, and Psychiatry. 83 (1): 4–5. doi:10.1136/jnnp-2011-301216. ISSN 1468-330X. PMID 22166990.
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  117. ↑ Iversen, Amy; Chalder, Trudie; Wessely, Simon (October 1, 2007). "Gulf War Illness: Lessons from medically unexplained symptoms". Clinical Psychology Review. MEDICALLY UNEXPLAINED SYMPTOMs. 27 (7): 842–854. doi:10.1016/j.cpr.2007.07.006. ISSN 0272-7358.
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  120. ↑ Wessely, Simon; Freedman, Lawrence (April 29, 2006). "Reflections on Gulf War illness". Philosophical Transactions of the Royal Society B: Biological Sciences. 361 (1468): 721–730. doi:10.1098/rstb.2006.1830. ISSN 0962-8436. PMC 1857735. PMID 16687274.
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  122. ↑ Hotopf, Matthew; Wessely, Simon (August 2005). "Can epidemiology clear the fog of war? Lessons from the 1990-91 Gulf War". International Journal of Epidemiology. 34 (4): 791–800. doi:10.1093/ije/dyi102. ISSN 0300-5771. PMID 15911546.
  123. ↑ Hotopf, M.; David, A.; Hull, L.; Ismail, K.; Unwin, C.; Wessely, S. (May 20, 2000). "Role of vaccinations as risk factors for ill health in veterans of the Gulf war: cross sectional study". BMJ (Clinical research ed.). 320 (7246): 1363–1367. doi:10.1136/bmj.320.7246.1363. ISSN 0959-8138. PMID 10818024.
  124. ↑ Murphy, Dominic; Hotopf, Matthew; Wessely, Simon (June 30, 2008). "Multiple vaccinations, health, and recall bias within UK armed forces deployed to Iraq: cohort study". BMJ (Clinical research ed.). 337: a220. doi:10.1136/bmj.a220. ISSN 1756-1833. PMC 2443597. PMID 18595928.
  125. ↑ 125.0 125.1 Fear, N.T.; Woodhead, C.; Greenberg, N.; Wessely, Simon (February 7, 2009). "Gulf war illnesses". The Lancet. 373 (9662): 462. doi:10.1016/S0140-6736(09)60170-7. ISSN 0140-6736. PMID 19200916.
  126. ↑ Horn, Oded; Hull, Lisa; Jones, Margaret; Murphy, Dominic; Browne, Tess; Fear, Nicola T.; Hotopf, Matthew; Rona, Roberto J.; Wessely, Simon (May 27, 2006). "Is there an Iraq war syndrome? Comparison of the health of UK service personnel after the Gulf and Iraq wars". Lancet. 367 (9524): 1742–1746. doi:10.1016/S0140-6736(06)68661-3. ISSN 1474-547X. PMID 16731269.
  127. ↑ Hotopf, Matthew; Hull, Lisa; Fear, Nicola T.; Browne, Tess; Horn, Oded; Iversen, Amy; Jones, Margaret; Murphy, Dominic; Bland, Duncan (May 27, 2006). "The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study". Lancet. 367 (9524): 1731–1741. doi:10.1016/S0140-6736(06)68662-5. ISSN 1474-547X. PMID 16731268.
  128. ↑ Cohn, Simon; Dyson, Clare; Wessely, S. (December 2008). "Early accounts of Gulf War illness and the construction of narratives in UK service personnel". Social Science & Medicine (1982). 67 (11): 1641–1649. doi:10.1016/j.socscimed.2008.09.004. ISSN 0277-9536. PMID 18829146.
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  130. ↑ Moncrieff, J.; Wessely, S.; Hardy, R. (March 1998). "Meta-analysis of trials comparing antidepressants with active placebos". The British Journal of Psychiatry: The Journal of Mental Science. 172: 227–231, discussion 232–234. doi:10.1192/bjp.172.3.227. ISSN 0007-1250. PMID 9614471.
  131. ↑ 131.0 131.1 Wessely, s. "In the culture of counselling, we all risk becoming victims" (PDF).
  132. ↑ 132.0 132.1 132.2 132.3 Arie, Sophie (September 21, 2017). "Simon Wessely: "Every time we have a mental health awareness week my spirits sink"". BMJ. 358: j4305. doi:10.1136/bmj.j4305. ISSN 0959-8138. PMID 28935658.
  133. ↑ Greenberg, Neil; Wessely, Simon; Devon, Madeleine; Eldridge, Rod; Cameron, Fiona; Hughes, Jamie Hacker (2005). "Going to war does not have to hurt: preliminary findings from the British deployment to Iraq". The British Journal of Psychiatry. 186 (6): 536–537. doi:10.1192/bjp.186.6.536. ISSN 0007-1250.
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  135. ↑ Wessely, s (Summer 2004). "When Being Upset Is Not A Mental Health Problem" (PDF). Psychiatry. 67 (2).
  136. ↑ Wessely, Simon (December 7, 2006). "London can take it - psychological reactions to terrorism from the blitz to Bin Laden". Gresham College. Retrieved July 16, 2019.
  137. ↑ Gilbody, Simon; Sheldon, Trevor; Wessely, Simon (April 29, 2006). "Should we screen for depression?". BMJ (Clinical research ed.). 332 (7548): 1027–1030. doi:10.1136/bmj.332.7548.1027. ISSN 1756-1833. PMC 1450055. PMID 16644833.
  138. ↑ Das-Munshi, Jayati; Rubin, G. James; Wessely, Simon (December 2006). "Multiple chemical sensitivities: A systematic review of provocation studies". The Journal of Allergy and Clinical Immunology. 118 (6): 1257–1264. doi:10.1016/j.jaci.2006.07.046. ISSN 0091-6749. PMID 17137865.
  139. ↑ Rubin, G. James; Das Munshi, Jayati; Wessely, Simon (March 2005). "Electromagnetic hypersensitivity: a systematic review of provocation studies". Psychosomatic Medicine. 67 (2): 224–232. doi:10.1097/01.psy.0000155664.13300.64. ISSN 1534-7796. PMID 15784787.
  140. ↑ Howard, L.M.; Wessely, S. (June 1995). "Psychiatry in the allergy clinic: the nature and management of patients with non-allergic symptoms". Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology. 25 (6): 503–514. ISSN 0954-7894. PMID 7648457.
  141. ↑ David, A.S.; Wessely, S. C. (January 1995). "The legend of Camelford: medical consequences of a water pollution accident". Journal of Psychosomatic Research. 39 (1): 1–9. ISSN 0022-3999. PMID 7760298.
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  157. ↑ Ross, Deborah (October 2011). "Mind the gap". The Spectator. The Spectator. Retrieved August 29, 2018.
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  165. ↑ Wessely S, Sharpe M, Hotopf M. Chronic Fatigue and its Syndromes. Oxford University Press, 1999. Page 325.
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  180. ↑ "Mortality of people with chronic fatigue syndrome: a retrospective cohort study in England and Wales from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) Register". The Lancet. 387 (10028): 1638–1643. April 16, 2016. doi:10.1016/S0140-6736(15)01223-4. ISSN 0140-6736.
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  182. ↑ Adamson, James; Ali, Sheila; Santhouse, Alastair; Wessely, Simon; Chalder, Trudie (October 2020). "Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: outcomes from a specialist clinic in the UK". Journal of the Royal Society of Medicine. 113 (10): 394–402. doi:10.1177/0141076820951545. ISSN 0141-0768.
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  185. ↑ "Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome". Gresham College. Retrieved August 29, 2018.
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  197. ↑ Huibers, Marcus J.H.; Wessely, Simon (July 2006). "The act of diagnosis: pros and cons of labelling chronic fatigue syndrome". Psychological Medicine. 36 (7): 895–900. doi:10.1017/S0033291705006926. ISSN 0033-2917. PMID 16403245.
  198. ↑ Jenkins, Rachel; Mowbray, James F. (January 29, 1993). Post Viral Fatigue Syndrome. Wiley. ISBN 978-0-471-93879-8.
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