Date sent:      	Sun, 9 Dec 2001 

Reply from the Chief Medical Officer

On 3rd November 2001 I posted a letter I had written to the
Chief Medical Officer, Professor Liam Donaldson, regarding the inclusion of
Chronic Fatigue Syndrome and M.E. within the "WHO Guide to Mental Health in
Primary Care"  under the classification of F48.0 (Mental, behavioural &
neurotic disorders)

URL:  http://www.psychiatry.ox.ac.uk/cebmh/whoguidemhpcuk/index.html


I have now received a short but interesting reply and felt you may wish to
read it.

Please see below.
                                          ______________


Mrs. Connie Nelson
Department of Health,
3rd December 2001
Quarry House,

Quarry Hill,

Leeds   L52  7UE

Dear Mrs.Nelson,

Thank you for your letter of 20th and 26th October respectively, to
Professor Donaldson concerning the WHO Guide to Mental Health in Primary
Care.   Further to my acknowledgement of 23rd November, I am now in a
position to give a more detailed reply.

I am sorry you are not happy with the references to CFS/ME in the WHO
Guide/web-site, although I note that the WHO web-site administrators have
made some amendments at your request.   WHO acts independently of national,
financial or other influences to provide impartial advice and expertise on
health matters.   The UK Government would therefore need very good evidence
before they would try to bring pressure to bear on a detailed area of work.
On this issue it would need to take into account the fact that despite a
great deal of commitment from professionals and voluntary organisations,
gaps remain in our knowledge about the cause, diagnosis and treatments for
some conditions, including CFS/ME.   A large number of different disorders
have therefore been put forward or implicated in trying to identify it's
causes.

You also mention in your letter that you would like to have the correct WHO
ICD-10 CFS/ME classification within the CFS/ME Working Group Report.   The
ICD-10 classification of diseases for  `Neurasthenia / Fatigue Syndrome' and
for `Post-Viral Fatigue Syndrome' / Benign Myalgic Encephalomyelitis' is
included in the CFS/ME Working Group Report.   It is however important to
remember that these are not diagnostic criteria, and are not used by
clinicians as such.

Yours sincerely,

Julia Pickard
NHS Disability Policy Branch