Date sent:      	Fri, 16 Aug 2002 
From:           	connie <connie.nelson@NTLWORLD.COM>
Subject:        	WHO Guide - 2nd edition


Hi Folks,

Earlier this week whilst attempting to compile an up to date complaint about
the WHO GUIDE to Mental Health in Primary Care, found at,
http://cebmh.warne.ox.ac.uk/cebmh/whoguidemhpcuk/
I noticed the website has been altered considerably since complaints were
first made almost a year ago. The website was last updated on Friday July19, 2002. It
would seem there's to be a 2nd edition of the book and a new project worker will be
employed from the 2nd September, to work on this.   As the GUIDE's website and the
downloadable Guide, available via the website, may be an indicator of what will be
considered for the forthcoming 2nd edition it would be beneficial if concerns over
the content are submitted to Mike Morgan,   m.morgan@iop.kcl.ac.uk   

Complaints made last year have made some difference as the website no longer makes
the erroneous claim, "Chronic Fatigue and Chronic Fatigue Syndrome - F48.0 (may be
referred to as M.E)"    It instead reads, " CHRONIC FATIGUE, FATIGUE SYNDROME &
NEURASTHENIA - F48.0" but there are references to Chronic Fatigue Syndrome
throughout.

At the link below you'll find the following paragraph.
 http://cebmh.warne.ox.ac.uk/cebmh/whoguidemhpcuk/disorders/f48-0.html

"Postviral fatigue syndrome and benign myalgic encephalomyelitis (classified
under G93.3 'neurological disorders') are diagnosed where there is excessive
fatigue following a viral disease and the symptoms do not fulfil the
criteria for F48.0.  ' Fatigue syndromes', both chronic and not, both with
and without an established physical precursor, may be classified under
'neurasthenia' F48.0.  In practice, there is extensive overlap in symptoms
(up to 96%). The choice of coding reflects different recording practices and
uncertainty about the aetiology of these syndromes. Although classification
is controversial, treatment is similar whatever choice is made about
coding."  

The GUIDE also continues to direct the user to the Institute of Psychiatry's, 
Chronic Fatigue / Chronic Fatigue Syndrome website at ;
http://cebmh.warne.ox.ac.uk/cebmh/whoguidemhpcuk/disorders/f48-0.html#resour
which informs the reader,
" The Institute of Psychiatry's website includes a full patient-management
package for more severe symptoms of Chronic fatigue syndrome. This includes
information about the disorder and suggestions to aid self-management. It is
a useful resource for the practitioner who is working with the patient to
overcome the condition."

Once at the Institute of Psychiatry's website the reader can then choose to read the
' History of CFS' which states; " CFS has officially replaced the term M.E. ( Myalgic
Encephalomyelitis), because there is no consistent evidence for the swelling of
nervous tissue that this name implies. It has also replaced the term Post Viral
Fatigue Syndrome, as the symptoms are not always associated with an initial viral
infection."

There are numerous areas, not detailed in this message, which are wholly
unsatisfactory both on the website and in the down loadable version of the
Guide.  

Please make sure your concerns about this GUIDE are made known.

Take care
Connie