The kind of "mental illness" we're talking about here with CFS & the Wessely/UK psychiatry school of though though is old school _neurosis_. You're not sick, you're neurotic. You want to save face by coming up with symptoms. You need validation from a doctor. You remain sick because of the 'secondary gain' you receive in terms of attention. You need to avoid personal responsibility and blame, and so on.
It's horrible stuff. For quotes from the horse's mouth, see: http://www.cfsinfo.be/Documentatie/AA%20%20Strijd%20classifi... , and hopefully you can see why his views have been so controversial.
It's true that CFS is something of a catch-all for a variety of illnesses, from post-viral syndromes (see Dr Lerner), hypothyroid problems, diet and gut-related illnesses (undiagnosed coeliac patients, for example), neurological syndroms (some people are helped by neurofeedback, and Jay Goldstein wrote some fascinating books on the neuroscience of CFS/ME), hormone disorders (e.g. adrenal, but also others), possible retroviruses (XMRV looks 95% unlikely, but a handful of people did well on antiretrovirals), possible hit-and-run viral brain injury (as Australian research has indicated) and on and on. Hell, I recently came across a guy who recovered almost immediately and totally after 30 years of debilitating fatigue by taking a relatively recent IGE-binding drug (Xolair). Plus, there's the potential of an underlying viral or other cause that in turn causes a differing array of symptoms.
The problem is not just that we don't know what CFS/ME is (to the extent that it's a uniform thing), but we're pretty lousy at dealing with all the other surrounding illnesses as well. (Hypothyroid is a great case in point, IGE is relatively new, etc etc,.)
What's pretty clear, however, is the vast, vast majority of these patients, whether suffering CFS for known or unknown reasons, are not neurotic, and for The Economist, or anyone, to insist that "neurosis" should be taken seriously as a basis for medical diagnosis and treatment in 2011 is simply appalling.
edit: ugh, Wessely, not Wessley. my bad.
> It does delegitimise the extremely severe nature of the illness.
How does merely positing a psychosomatic origin for the syndrome "delegitimise" its "extreme severity"? Or is it you thinking that mental health is somehow less important than physical health, which doesn't even make sense considering the brain is an organ too?
> Psycho-social explanations of CFS seem to be nothing more than "hysteria" rebadged for more modern times. It's easier to say "Well, maybe it's your fault!" than to accept the hopelessness of not knowing what's going on.
Uh huh. And it's easier to take the idea of mental health being relevant as a personal insult, like people are saying it's one's own fault, than to accept the hopelessness of not knowing there's a magical cure as soon as the doctors discover the sole physical cause.
Again, I really want to read further on research being done on CFS and other subjective and idiopathic syndromes. It's interesting from a medical and social standpoint and I'm close with several people who suffer with such issues. But I've also seen their blind spots related to the issue. I'd like to hear more on the work that's disproven psychiatric origins of the syndrome, since while the editorial touched on Wessley it seemed more to be talking about the need to explore all possible causes and solutions of a problem affecting many.