Royal College of Physicians of London
"We do not believe that an acceptable definition of CFS/ME has been adhered to. For instance, the commonly accepted definition for research and diagnosis is that of Fukuda et al 1994. The consensus group here have presented their own definition, which really describes fatigue for four months in the adult, with one, of a limited number, of other symptoms. This opens up the diagnosis from CFS/ME into a wider remit of fatigue disorders and not what is Generally accepted in medical practice as the heterogeneous group of fatigue conditions known as CFS. […]It also states the therapies of first choice should be CBT or GET. We feel that these are not either/or therapies, but quite different in their total effects and would be additive. The major studies on GET have only been used in ambulant patients who are able to travel, and never in isolation but always with a General management package, including recommendations for lifestyle changes etc. Clinical evidence and patient experience suggests strongly that some patients may be worsened with GET and more emphasis should be stated that it should be used in individuals who are able to sustain regular day to day activities and that appropriate supervision would be required.
"[…] This is managing setbacks: We think this is a potentially dangerous statement, that with increase in CFS/ME symptoms, exercise or physical activity should be maintained if possible to avoid the negative effects of deconditioning. not aware of any clinician who would make this recommendation, except in a very mildly affected patient. There are many reasons for setbacks in CFS, including excess physical activity or stress. If this is the case, and activity levels remain unchanged, the patient is at risk of having a more major or serious relapse."