In the first years after the introduction of the diagnosis
chronic fatigue syndrome, the condition was often mocked in the media, for example being described as "yuppie flu". Wessely and his co-workers verified that this stereotype was inaccurate, substantiating an association between
autonomic dysfunction and chronic fatigue syndrome and providing reliable data on the prevalence of CFS in the community, showing that it has become an important
public health issue. Other work on CFS included the development of new measurement tools, establishing the lack of relationship between
hyperventilation and CFS, discovery of an
endocrine "signature" for CFS that differed from
depression and that prior depressive illnesses were likely linked to the condition in some cases. Wessely and his colleagues, using
randomised controlled trials and follow-up studies, developed a rehabilitation strategy for patients that involved
cognitive behavioural and
graded exercise therapy, which was claimed to be effective in reducing symptoms of CFS (a condition that otherwise lacks a cure or unequivocally successful treatment) in ambulant (non-severely affected) patients. Other studies looked at the professional and popular views of CFS, neuropsychological impairment in CFS, and
cytokine activation in the illness. Some of his other written work includes a history of CFS, numerous reviews, and co-authoring the 1998 book
Chronic fatigue and its syndromes. Wessely believes that CFS generally has some organic trigger, such as a virus, but that the role of psychological and social factors are more important in perpetuating the illness, otherwise known as the "cognitive behavioural model" of CFS, and that treatments centred around these factors can be effective. He describes the cognitive behavioural model as follows: "According to the model the symptoms and disability of CFS are perpetuated predominantly by dysfunctional illness beliefs and coping behaviours. These beliefs and behaviours interact with the patient's emotional and physiological state and interpersonal situation to form self-perpetuating vicious circles of fatigue and disability... The patient is encouraged to think of the illness as 'real but reversible by his or her own efforts' rather than (as many patients do) as a fixed unalterable disease". A 2019 review found that the cognitive behavioral model of CFS underpinning the promotion of CBT lacks high-quality evidential support and that "There is little scientific credibility in the claim that psycho-behavioural therapies are a primary treatment for this illness." In 2009, a paper was published in
Science stating that the XMRV virus was found in two-thirds of CFS patients. Wessely collaborated with experts in retrovirology at Imperial College London, sharing with them stored DNA samples from the King's CFS unit, and providing the first proof that XMRV was not the cause of CFS/ME. Wessely also said that this research fails to model the role that childhood abuse, psychological factors, and other infections may play in the illness. The
Science paper was retracted but not before there was intense criticism of the King's/Imperial failure to replicate, claiming that the patients seen at King's did not have CFS/ME. The team responded showing this to be unfair.
Opposition and criticism In an interview published by
The Lancet, Wessely discusses the controversy relating to his work on Gulf War syndrome and chronic fatigue syndrome. He stated that, in hindsight, he was keen to get published and could have been more diplomatic and admits he is now better at handling controversy. He has been described as both "the most hated doctor in Britain" and "one of the most respected psychiatrists working in Britain today".
Malcolm Hooper, the
Countess of Mar, and others have strongly criticised Wessely including specific allegations that he said are myths. In a 2002 article on chronic fatigue syndrome,
The Guardian characterised the criticisms of one group of patients as a "vendetta". Wessely has repeatedly stated he has been the subject of numerous threats and personal attacks, and that "militants" have even made threats to his life. "It is a relentless, vicious, vile campaign designed to hurt and intimidate... For some years now,all my mail has been X-rayed. I have speed dial phones and panic buttons at police request and receive a regular briefing on my safety and specific threats." Wessely gave up research into CFS around 2001, and as of 2011 his clinical work was with members of the armed forces; he said: "I now go to Iraq and Afghanistan, where I feel a lot safer". ==Military health==