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Under proper supervision first-line treatments for chronic fatigue syndrome are effective and safe but research into second-line treatment is required.
In the paper by Smith and Wessely,1 problems are outlined in commissioning services in Scotland2 that accommodate the acrimonious debate between the views of those who consider myalgic encephalomyelitis (ME) to be a neurological condition versus an evidence-based medicine view that chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a condition of uncertain aetiology improved by graded exercise treatment (GET) and cognitive behaviour therapy (CBT).3 The debate threatens to hinder the development of safe, cost-effective and clinically effective services for patients with CFS/ME, and to stifle further research building on important discoveries on diagnosis, the limited effectiveness of current treatments and the validity of ‘objective’ outcome measures.
A wide range of diagnostic criteria …
Contributors RM planned, conducted and wrote the submitted editorial commentary. He is the guarantor of the editorial commentary.
Funding RM is currently funded as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire; he is also funded by a central grant from the National Institute of Health Research (NIHR) and further funding from Nottinghamshire Healthcare Trust, University of Nottingham, other NHS Trusts in CLAHRC. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests RM has received funding from the UK Medical Research Council, the NHS and the Linbury Trust to carry out randomised controlled trials of graded exercise and rehabilitation in CFS/ME.
Provenance and peer review Commissioned; internally peer reviewed.