The CFIDS Association of America sent the following letter to the King's College WHO
Centre today. It is virtually identical to the letter sent to Dr. Brundtland of WHO on Septmber 5th, with
minor modification to the second paragraph.
The CFIDS Association of America
Professor Rachel Jenkins
WHO Collaborating Centre
Institute of Psychiatry
London SE5 8AF
Via e-mail: email@example.com
The CFIDS Association of America, Inc., has recently learned of a booklet titled
WHO Guide to Mental Health in Primary Care, developed by your World Health Organization's Collaborating
Centre for Research and Training for Mental Health at the Institute of Psychiatry, Kings College, London,
and published in book form and on the Internet at http://www.whoguidemhpcuk.org/.
CFIDS Association joins with Action for ME, IMEGA-e, the ME Association, and other international CFS/ME
organizations in taking grave exception to the section of this booklet on chronic fatigue syndrome (CFS),
as the information is inconsistent with current research on CFS as well as with WHO 's own International
Classification of Diseases, 10th revision.
The ICD-10 index codes "chronic fatigue syndrome" at
G93.3 in the chapter on the nervous system and the category "other diseases of the brain." However, the
Kings College booklet lists CFS at F48.0 in the category "neurasthenia," a designation which specifically
excludes code G93.3 illnesses.
The diagnostic criteria for CFS in the booklet are not consistent
with the internationally accepted criteria published in the Annals of Internal Medicine in 1994. Rather,
they reflect relatively loose criteria used only by a small number of researchers and clinicians in the
U.K. It is surprising that the 1994 international criteria would not be provided, given that Dr. Simon
Wessely, an author of the CFS section of the WHO Guide, is also an author on the 1994 international definition,
and the looser criteria predate the international definition, which is considered to replace earlier definitions.
is not considered by leading researchers of the illness
to be a mental disorder, as indicated by the WHO Guide. Numerous biological
abnormalities of the immune, endocrine and circulatory systems have been
documented, although the etiology of CFS is not yet known. These abnormalities
are not described or referenced in the WHO Guide. Risk and perpetuating factors
noted in the accompanying article on CFS at (link no longer
active) have never been proven to be associated with CFS. In fact, the cause(s), precipitant(s) and
of CFS are not yet known, therefore the WHO Guide contains misleading information when it states that
lifestyle factors are responsible for the development of CFS.
Because the information on chronic
fatigue syndrome in the WHO Guide to Mental Disorders in Primary Care is inaccurate, incomplete and inconsistent
with WHO's own guidance in the ICD-10, The CFIDS Association of America calls for the immediate removal
of this section from the booklet.
It also appears that WHO has
departed from the common requirement of a disclaimer for this booklet, such as
the one used in a WHO publication on substance abuse
document is not a formal publication of the World Health Organization (WHO) and all rights are reserved
by the Organization. The views expressed in documents by named authors are solely the responsibility of
Please find attached a CFS Fact Sheet outlining current CFS research findings,
most of which are overlooked by the King's College booklet authors. The CFIDS Association of America would
be pleased to provide additional supporting documentation to WHO as it addresses this complaint. If you
require additional information, please contact me by fax at
704-365-9755, e-mail at firstname.lastname@example.org
or telephone at 704-364-0466.
K. Kimberly Kenney
cc: Dr J.M. Bertolote, Mental Behavioural Disorders, WHO,
Jo Paton, Research Worker, WHO Collaborating Centre, email@example.com
Ellen Goudsmit, IMEGA-e, firstname.lastname@example.org