ME/CFS Primer/Education Bulletins Letter to the Editor
Response to Professor White's comments on my paper published in the Bulletin of the IACFS/ME:

Sampson D.P. (2010) Close Analysis of a Large Published Trial Into Fatigue Syndromes and Mood Disorders That Occur After Documented Viral Infection. Bulletin of the IACFS/ME, Vol 18, Issue 2, Summer 2010.

Firstly I welcome Prof. White’s acknowledgement that broad based definitions of ME/CFS that include co-morbid mood disorder/psychiatric illness are predicted by different factors than those that do not, and that subjects with purely psychiatric disorders were included in broad based definitions of ME/CFS such as the Oxford criteria.

However he seems not to have grasped the main focus of my paper—the inclusion of patients with psychiatric reasons for their fatigue alongside those with bona fide ME/CFS. It is patently clear from my analysis of his own data and the risk factors that accompany these two groups of patients that they are completely different illnesses/conditions.

This is at best tautology and at worst very poor science.

Not only in the study he refers to showing Graded Exercise as an effective treatment for CFS/ME (which ostensibly excluded patients with co-morbid mood disorder) were 30% of the participants receiving normal dose antidepressant therapy or low dose tricyclic antidepressant hypnotic medication but furthermore those with appreciable sleep disturbance (one of the hallmarks of CFS/ME) were excluded. As nearly 90% of even CDC defined CFS sufferers report profound sleep disturbance) this was clearly not a study of ME/CFS but of psychogenic fatigue with no physical basis.

Finally he refers to the PACE trial, the largest ever trial of Graded Exercise of which he is Principal Investigator—the results of which have not yet been announced.

It is of interest that the ME/CFS criteria selected for use in this study are the Oxford Criteria, which preferentially select patients with psychiatric reasons for their fatigue as his own data clearly demonstrate.

No other researchers examining ME/CFS in the world currently utilize such broad criteria as they clearly fail to exclude patients with primary psychiatric diagnosis in the absence of physical symptoms.

—David Sampson, BSc (Hons), MSc, MBPsychS.