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A MODERN PERSPECTIVE ON SOME OF THE MOST HIGHLY CITED JNNP PAPERS OF ALL TIME
The nature of fatigue: a comparison of chronic “postviral” fatigue with neuromuscular and affective disorders
  1. Simon C Wessely
  1. Correspondence to Professor S Wessely, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; simon.wessely{at}kcl.ac.uk

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The nature of fatigue: a comparison of chronic “Postviral” fatigue with neuromuscular and affective disorders1

Authors: S Wessely, R Powell

Year published: 1989

Number of times cited: 344

Simon C Wessely from King's College London describes starting out in the early years of chronic fatigue syndrome with his first ‘proper’ paper

In 1987 I was a senior registrar on the Maudsley psychiatry training scheme when I was moved at short notice up to the National Hospital for Neurology, London, because the current SpR, Ray Dolan, had just been promoted to consultant. I soon expressed an interest in seeing one group of patients who were always getting referred to the liaison service, and frankly were not popular with many of the neurologists who ran the place. It wasn't the fault of the patients—they had symptoms that might have had a neurological explanation. But when the neurologists drew a blank, the patients soon got the message, whether rightly or wrongly, that the neurologists thought that they were at best suffering from depression, at worst making it all up, either of which appeared to be confirmed when the next port of call was myself. I still treasure the briefest but still most unintentionally revealing referral letter I have ever received—“Dear Simon, Please see this patient. There is nothing wrong with her”.

That something was wrong was clear, but what exactly? The Americans would introduce the term chronic fatigue syndrome (CFS) a year later, which at least gave a label that doctors could use, but in 1987 it was known as ‘ME’, short for myalgic encephalomyelitis, which further irritated the neurologists. In the media it was known as ‘yuppie …

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