Simon Wessely

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Sir Simon Wessely
Born Simon Wessely
1956 (age 57–58)
Sheffield, England, UK
Education
Years active 1978-Present
Medical career
Profession Psychiatrist
Research Chronic Fatigue Syndrome

Sir Simon Charles Wessely (born Sheffield, 1956) is a British psychiatrist. He is Professor of Psychological Medicine at the Institute of Psychiatry, King's College London and Head of its department of psychological medicine, Vice Dean for Academic Psychiatry, Teaching and Training at the Institute of Psychiatry, as well as Director of the King's Centre for Military Health Research. He is also honorary Consultant Psychiatrist at King's College Hospital and the Maudsley Hospital, as well as Civilian Consultant Advisor in Psychiatry to the British Army.[1] He was knighted in the 2013 New Year Honours for services to military healthcare and to psychological medicine.[2] In 2014 he was elected president of the Royal College of Psychiatrists.[3]

Training and interests

After attending King Edward VII School in Sheffield from 1968 to 1975, Wessely studied at Trinity Hall, Cambridge (BA 1978), University College, Oxford (BM BCh 1981), and the London School of Hygiene and Tropical Medicine (MSc 1989). In 1993 the University of London conferred upon him the degree of Doctor of Medicine.[4]

Wessely completed a medical rotation in Newcastle. After attaining medical membership he studied psychiatry (his primary interest) at the Maudsley in 1984. His 1993 doctoral thesis was on the relationship between crime and schizophrenia. Post-doctoral studies included a year at the National Hospital for Neurology and Neurosurgery and a year studying epidemiology at the London School of Hygiene and Tropical Medicine.[1] In 1999 he was elected fellow of the U.K. Academy of Medical Sciences (FMedSci).[5]

Wessely's main research interests lie in the "grey areas" between medicine and psychiatry, clinical epidemiology and military health. His first paper was entitled "Dementia and Mrs. Thatcher",[6] since when he has published over 600 papers on subjects including epidemiology, post traumatic stress, medicine and law, history of psychiatry, chronic pain, somatisation, Gulf War illness, chemical and biological terrorism and deliberate self-harm. He has published most widely on aspects of chronic fatigue syndrome, including its aetiology, history, psychology, immunology, sociology, epidemiology and treatment.[1]

In private life, Wessely is married and has two sons. His interests include skiing and history, and he cycled annually from London to Paris between 2006 and 2012, to raise money for veterans' charities.[7]

Work on chronic fatigue syndrome

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".[8][full citation needed] Wessely and his co-workers verified that this stereotype was inaccurate, substantiating an association between autonomic dysfunction and chronic fatigue syndrome[9] and providing reliable data on the prevalence of CFS in the community, showing that it has become an important public health issue.[10] Other work on CFS included the development of new measurement tools,[11] establishing the lack of relationship between hyperventilation and CFS,[12] discovery of an endocrine "signature" for CFS that differed from depression[citation needed] and that prior depressive illnesses were likely linked to the condition in some cases.[13]

Wessely and his colleagues, using randomised controlled trials and follow-up studies,[14] developed a rehabilitation strategy for patients that involved cognitive behavioral and graded exercise therapy, that is effective in reducing symptoms of CFS (a condition that otherwise lacks a cure or unequivocally successful treatment) in ambulant (non-severely affected) patients.[15][16] Other studies looked at the professional and popular views of CFS,[17] neuropsychological impairment in CFS,[18] and cytokine activation in the illness.[19] Some of his other written works include a history of CFS,[20] numerous reviews and co-authoring the 1998 book Chronic fatigue and its syndromes.[21] He has also established the first National Health Service programme solely devoted to patients with CFS, and continues to provide ongoing treatment with patients at King's College Hospital.[22]

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. Wessely 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".[15][23][24]

In an interview with the BMJ, Wessely indicated although viruses and other infections are clearly involved in triggering the onset of CFS, treating them is at the moment not part of management, using the analogy of a hit and run accident in which finding out the make or number plate of the car that hits you doesn’t help the doctor trying to mend the injury, repeating that we are "in the business of rehabilitation".[25]

Commenting on a now-retracted science paper that stated XMRV virus was found in two thirds of CFS patients, Wessely said this research fails to model the role childhood abuse, psychological factors, and other infections may play in the illness.[26]

Opposition and criticism

In an interview published by The Lancet,[27] Wessely discusses the controversy relating to his work on Gulf War syndrome and chronic fatigue syndrome. With hindsight he states that he was keen to get published, could have been more diplomatic, and is now better at handling controversy.[28] He has been described as both "the most hated doctor in Britain" and "one of the most respected psychiatrists working in Britain today".[29][30]

Although Wessely has studied physical markers and allows the possibility of a biological basis to CFS, he is not confident of such a basis and remains sceptical.[31] He has also suggested that campaigners are motivated "not so much by a dispassionate thirst for knowledge but more by an overwhelming desire to get rid of the psychiatrists" from the area of chronic fatigue syndrome, despite having himself published research which concluded that "the stereotype of CFS sufferers as perfectionists with negative attitudes toward psychiatry was not supported".[32][33] When asked about severely affected bed-ridden patients, Wessely said "in that kind of disability, psychological factors are important and I don't care how unpopular that statement makes me."[23]

Some activists who favour a physical aetiology for CFS have strongly criticized Wessely, including Prof. Malcolm Hooper,[34] and the Countess of Mar.[35] In an article on chronic fatigue syndrome, The Guardian calls criticism from these activists a "vendetta".[31] Wessely has been the subject of numerous threats and personal attacks, and extremists have even made threats to his life.[36] "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 claims to have given up research into CFS 10 years ago although he continues his clinical work with sufferers but his main research interests are now in the health of serving and ex serving member of the armed forces. "I now go to Iraq and Afghanistan, where I feel a lot safer".[37]

Military health

More recently, Wessely's work was the first to show that service in the 1991 Gulf War had had a significant effect on the health of UK servicemen and women. Other work suggested a link to particular vaccination schedules used to protect against biological warfare, and also a link with psychological stress. His group also confirmed that classic psychiatric injury, post-traumatic stress disorder (PTSD), was not a sufficient explanation for the observed health problems. He and his colleagues in the medical school showed persisting evidence of immune activation, but failed to show that exposure to organophosphate or cholinesterase inhibitor agents had caused chronic neurological damage. The group also showed that many veterans who left the Armed Forces with persisting mental health problems have found it difficult to access National Health Service (NHS) services.[citation needed]

While this work, Wessely's evidence to the Lloyd Inquiry,[38] and the work of other investigators was crucial in categorising Gulf War Syndrome as a verifiable consequence of service in the Gulf, which resulted in affected Gulf War veterans being able to receive war pensions, Wessely does not believe that Gulf War Syndrome exists as a distinct illness, stating "Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest".[39] Instead Wessely favors psychological explanations for what he views to be a 'Gulf War health effect' which he believes to be caused by stress, specifically troops' anxiety about chemical weapons and vaccines, as well as misinformation about Gulf War Syndrome.[40]

Wessely's main current research is around various aspects of military health, including further work on the outcome of Gulf War illness, psychological stressors of military life, risk and risk communication, risk and benefits of military service, screening and health surveillance within the Armed Forces, social and psychological outcomes of ex service personnel, and historical aspects of military psychiatry. In 2006 he and his team completed a study on the health of 20,000 UK military personnel who took part in the invasion of Iraq. The results were published in the medical journal The Lancet.[41]

In 2010 they published a second study[42] looking at the impact of both Iraq and Afghanistan on the health of personnel showing that there had been no overall increase in mental health problems, despite the increased operational tempo and numbers of deployments, but that those in the reserves and those with direct combat exposure continued to be more at risk. Alcohol problems continued to be more frequent that post traumatic stress disorder.

He is a trustee of the charity Combat Stress[43] that provides help for service personnel with mental health problems and recently spent a sabbatical in the Department of War Studies at King's College London.[1]

Other interests

Wessely also has a long standing interest in how normal people react to adversity, and what, if any, responses are appropriate. He was a co-author of an influential Cochrane Review showing that the conventional response – to offer people who have been involved in disaster immediate psychological debriefing – was not only ineffective, but possibly did more harm than good.[44] Since then he has published on civilian reactions to the Blitz, and latterly an early study of reactions to the July 7, 2005 London bombings,[45] the Litvenko affair,[46] and swine flu.[47]

In many venues, he has argued that people are more resilient than we give them credit for, and that the best thing we can do in the immediate aftermath of trauma is to offer practical support and encourage people to turn to their own social networks, such as family, friends, colleagues or family doctor.[48][49] However, after a few months, when most distress has reduced, then for the minority who are still psychologically distressed or disabled it is appropriate to offer evidence-based psychological interventions.[44]

Publications

Wessely has co-authored books on CFS, psychological reactions to terrorism, randomised controlled trials, and a history of military psychiatry, From Shell Shock to PTSD.[50]

Honours

For his work on CFS, Wessely was awarded the Jean Hunter Prize in 1997[citation needed] by the Royal College of Physicians[51][52] and was co-winner of the John Maddox Prize 2012[53] sponsored by Nature and the Ralph Kohn Foundation, and organised by Sense About Science on whose advisory council he serves.[54] The award is given to individuals who have promoted sound science and evidence on a matter of public interest, with an emphasis on those who have faced extreme difficulty or opposition in doing so, as Wessely has done in researching neuropsychiatric elements to CFS despite threats to his life. Some, however, have objected to this award being given to him due to concerns over the quality of his research.[55]

To balance these criticisms academic supporters would point out that he was appointed[56] as a Foundation Senior Investigator of the National Institute for Health Research, which is given on very strict criteria[57] including analysis of metrics/citations. The college of NIHR Senior Investigators is drawn from the most pre-eminent NIHR-funded researchers selected through annual competitions. He was also elected Fellow of the Academy of Medical Sciences,[58][59] the medical equivalent of the Royal Society, in 1999. Only 40 are honoured per year, and it is the highest honour and professional recognition in UK academic medical science.

His 2013 Knighthood was for services to Military healthcare and psychological medicine.[2]

In 2014, Wessely was elected president of the Royal College of Psychiatrists. He announced his priorities to include parity between physical and mental health, improving the image of psychiatry and psychiatrists, improving recruitment into the specialty, and ensuring excellence in education and training.[3]

Notes

  1. ^ a b c d "Official homepage". Institute of Psychiatry, King's College London. 2007-07-04. Retrieved 2007-09-30. 
  2. ^ a b The London Gazette: (Supplement) no. 60367. p. 1. 2012-12-29. Retrieved 2012-12-29.
  3. ^ a b "RCPsych Presidential Election results announced". Royal College of Psychiatrists. 14 January 2014. Retrieved 21 January 2014. 
  4. ^ Black, A; Black, C (December 2007). "Wessely, Prof. Simon Charles". Who's Who 2008, online edition. Oxford University Press. Retrieved 2008-03-27. 
  5. ^ "Professor Simon Wessely FMedSci". Fellows Directory. Retrieved 2014-01-02. 
  6. ^ Deary, IJ; Wessely, S; Farrell, M (21–28 December 1985). "Dementia and Mrs Thatcher". Br Med J (Clin Res Ed) 291 (6511): 1768. doi:10.1136/bmj.291.6511.1768. PMC 1419190. PMID 3936580. 
  7. ^ "Pedal to Paris September 2007". King's Centre for Military Health Research. 2007-09-28. Retrieved 2007-09-30. 
  8. ^ "Cover story". Newsweek. November 1990. 
  9. ^ Winkler, AS; Blair, D; Marsden, JT; Peters, TJ; Wessely, S; Cleare, AJ (February 2004). "Autonomic function and serum erythropoietin levels in chronic fatigue syndrome". Journal of Psychosomatic Research 56 (2): 179–183. doi:10.1016/S0022-3999(03)00543-9. PMID 15016575. 
  10. ^ Wessely, S (1995). "The epidemiology of chronic fatigue syndrome". Epidemiologic Reviews 17 (1): 139–151. PMID 8521932. (subscription required (help)). 
  11. ^ Wessely, S (April 1992). "The measurement of fatigue and chronic fatigue syndrome". Journal of the Royal Society of Medicine 85 (4): 189–190. PMC 1294719. PMID 1433056. 
  12. ^ Saisch, SG; Deale, A; Gardner, WN; Wessely, S (January 1994). "Hyperventilation and chronic fatigue syndrome". Q. J. Med. 87 (1): 63–7. PMID 8140219. 
  13. ^ Harvey, SB; Wadsworth, M; Wessely, S; Hotopf, M (July 2008). "The relationship between prior psychiatric disorder and chronic fatigue: evidence from a national birth cohort study". Psychol Med 38 (7): 933–40. doi:10.1017/S0033291707001900. PMC 3196526. PMID 17976252. 
  14. ^ Deale, A; Chalder, T; Marks, I; Wessely, S (March 1997). "Cognitive behavior therapy for chronic fatigue syndrome: a randomized controlled trial". Am J Psychiatry 154 (3): 408–14. PMID 9054791. 
  15. ^ a b Sharpe, M; Chalder, T; Palmer, I; Wessely, S (May 1997). "Chronic fatigue syndrome. A practical guide to assessment and management". Gen Hosp Psychiatry 19 (3): 185–99. doi:10.1016/S0163-8343(97)80315-5. PMID 9218987. 
  16. ^ Price, JR; Mitchell, E; Tidy, E; Hunot, V (2008). "Cognitive behaviour therapy for chronic fatigue syndrome in adults". In Price, Jonathan R. Cochrane Database Syst Rev (3): CD001027. doi:10.1002/14651858.CD001027.pub2. PMID 18646067. 
  17. ^ MacLean, G; Wessely, S (March 1994). "Professional and popular views of chronic fatigue syndrome". BMJ 308 (6931): 776–7. doi:10.1136/bmj.308.6931.776. PMC 2539637. PMID 8142836. 
  18. ^ Joyce, E; Blumenthal, S; Wessely, S (May 1996). "Memory, attention, and executive function in chronic fatigue syndrome". J. Neurol. Neurosurg. Psychiatr. 60 (5): 495–503. doi:10.1136/jnnp.60.5.495. PMC 486360. PMID 8778252. 
  19. ^ Skowera, A; Cleare, A; Blair, D; Bevis, L; Wessely, SC; Peakman, M (February 2004). "High levels of type 2 cytokine-producing cells in chronic fatigue syndrome". Clin. Exp. Immunol. 135 (2): 294–302. doi:10.1111/j.1365-2249.2004.02354.x. PMC 1808936. PMID 14738459. 
  20. ^ Wessely, S (October 1991). "History of postviral fatigue syndrome". Br. Med. Bull. 47 (4): 919–41. PMID 1794091. 
  21. ^ Hotopf, Matthew; Wessely, Simon; Sharpe, Michael (1998). Chronic fatigue and its syndromes. Oxford [Oxfordshire]: Oxford University Press. ISBN 0-19-263046-6. 
  22. ^ "GMC biographical sketch: Professor Simon Wessely". General Medical Council. Retrieved 2008-12-18. [dead link]
  23. ^ a b Wilson, Clare (2009-03-13). "Mind over body?". New Scientist 361 (2699): 599. Bibcode:1993Natur.361..599S. doi:10.1038/361599a0. 
  24. ^ Chalder, T; Deale, A; Sharpe, M; Wessely, S (2002). Manual of cognitive behavioural treatment for CFS, Appendix 2. 
  25. ^ Chronic fatigue syndrome. BMJ Group (Podcasts). 2010-03-05. "At approximately 11 minutes 15 seconds into the podcast, Simon Wessely states: "We’re not going to go doing more and more tests to find out what was the virus because, frankly, even if we found it there's nothing we're going to do about it. We're in the business of rehabilitation."" 
  26. ^ Callaway, Ewen (2009-10-08). "Chronic fatigue syndrome linked to 'cancer virus'". New Scientist. Retrieved 2010-10-31. 
  27. ^ "Lunch with The Lancet — Simon Wessely". March 2007. Retrieved 2013-01-19. 
  28. ^ Watts, Geoff; G (May 2007). "Simon Wessely". Lancet 369 (9575): 1783. doi:10.1016/S0140-6736(07)60802-2. PMID 17531873. 
  29. ^ Marsh, Stefanie (2011-08-06). "Doctor's hate mail is sent by the people he tried to cure". The Times (London). 
  30. ^ Wessely, Simon. "News". Retrieved 2012-11-16. 
  31. ^ a b Burne, Jerome (2002-03-30). "Special report: battle fatigue". The Guardian (London). Retrieved 2008-05-15. 
  32. ^ Wessely, S (2009). "Surgery for the treatment of psychiatric illness: the need to test untested theories". Journal of the Royal Society of Medicine 102 (10): 445–51. doi:10.1258/jrsm.2009.09k038. PMC 2755332. PMID 19797603. Retrieved 2009-10-11. 
  33. ^ Wood, B; Wessely, S (October 1999). "Personality and social attitudes in chronic fatigue syndrome". J Psychosom Res 47 (4): 385–97. doi:10.1016/S0022-3999(99)00025-2. PMID 10616232. 
  34. ^ "Evidence submitted by Professor Malcolm Hooper (NICE 07)". Select Committee on Health. Parliament of the United Kingdom. March 2007. Retrieved 2009-10-02. 
  35. ^ "House of Lords Debate 16 April 2002". http://www.publications.parliament.uk. Retrieved 2013-01-19. 
  36. ^ McKie, Robin (2011-08-21). "Chronic fatigue syndrome researchers face death threats from militants: Scientists are subjected to a campaign of abuse and violence". London: The Observer. 
  37. ^ Hawkes, N (2011). "Dangers of research into chronic fatigue syndrome". BMJ (Clinical research ed.) 342: d3780. doi:10.1136/bmj.d3780. PMID 21697226. Retrieved 2013-01-19. 
  38. ^ "Report of the Lloyd Inquiry ("Gulf War Illness Public Inquiry")". 2004-11-17. 
  39. ^ "Two decades on, battle goes on over 'Gulf War Syndrome'". BBC. 2011-01-16. Retrieved 2013-01-19. 
  40. ^ "US in U-turn over Gulf war syndrome". New Scientist. 2004-11-03. 
  41. ^ Hotopf, M; Hull, L; Fear, NT et al. (2006). "The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study". Lancet 367 (9524): 1731–41. doi:10.1016/S0140-6736(06)68662-5. PMID 16731268. 
  42. ^ "What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? — A cohort study". 
  43. ^ "Our Patron and Trustees". Combat Stress. 
  44. ^ a b Rose, S; Bisson, J; Churchill, R; Wessely, S (2002). "Psychological debriefing for preventing post traumatic stress disorder (PTSD)". In Rose, Suzanna C. Cochrane database of systematic reviews (Online) (2): CD000560. doi:10.1002/14651858.CD000560. PMID 12076399. 
  45. ^ Rubin, GJ; Brewin, CR; Greenberg, N; Simpson, J; Wessely, J; Wessely, S (2005). "Psychological and behavioural reactions to the bombings in London on 7 July 2005: cross sectional survey of a representative sample of Londoners". BMJ 331 (7517): 606. doi:10.1136/bmj.38583.728484.3A. PMC 1215552. PMID 16126821. 
  46. ^ Rubin, GJ; Page, L; Morgan, O; Pinder, RJ; Riley, P; Hatch, S; Maguire, H; Catchpole, M; Simpson, J; Wessely, S (2007). "Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis". BMJ (Clinical research ed.) 335 (7630): 1143. doi:10.1136/bmj.39367.455243.BE. PMC 2099556. PMID 17975252. 
  47. ^ Rubin, GJ; Amlot, R; Page, L; Wessely, S (2009). "Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey". BMJ (Clinical research ed.) 339: b2651. doi:10.1136/bmj.b2651. PMC 2714687. PMID 19574308. 
  48. ^ Wessely, S (2005). "The London attacks--aftermath: Victimhood and resilience". N. Engl. J. Med. 353 (6): 548–50. doi:10.1056/NEJMp058180. PMID 16093462. 
  49. ^ Wessely, Simon (July 2005). "The bombs made enough victims - let's not make more: A leading psychiatrist argues that the last thing Londoners need now is trauma counselling". Spiked-Online.com. 
  50. ^ Wessely, Simon; Jones, Edgar (2005). Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War. Psychology Press. ISBN 1-84169-580-7. 
  51. ^ "RAE 2001 — Submissions". Retrieved 2013-01-19. 
  52. ^ "Parliament proceedings". Parliament of the United Kingdom. 2004-01-22. Retrieved 2008-12-18. 
  53. ^ "The John Maddox Prize". 
  54. ^ "Advisory council". 
  55. ^ Manning, Sanchez (2012-11-25). "ME: Bitterest row yet in a long saga". London: Independent.co.uk. 
  56. ^ "Senior Investigators Directory". Retrieved 2013-01-19. 
  57. ^ "Types of Membership". Retrieved 2013-01-19. 
  58. ^ "Professor Sir Simon Wessely FMedSci". Academy of Medical Sciences. Retrieved 2013-01-19. 
  59. ^ "Election to the Fellowship". Academy of Medical Sciences. Retrieved 2013-01-19. 

External links

  • Official homepage
  • KCL staff page
  • KCL.ac.uk - The King's Centre For Military Health Research (KCMHR) is a joint initiative of the Institute of Psychiatry and the Department of War Studies at King's College London (Wessely's webpage at King's College)
  • KCL.ac.uk - "Health & Wellbeing of UK Armed Forces Personnel: Professor Simon Wessely - Principal Investigator", KCMHR