Extract from a response from Jo Paton,
WHO Collaborating Centre for Research and Training for Mental Health, Institute of Psychiatry, Kings College London, 16 September 2001 to the late Connie Nelson:
The ME Action UK site owned by Stephen Ralph is no longer available, but a copy of Ms Paton's response can be obtained from:
https://web.archive.org/web/20101009130340/http://www.meactionuk.org.uk/whomisc.htm
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2. Classification of Fatigue Syndrome/Chronic Fatigue under ICD-10
We have sought clarification of this matter from WHO and quote below from a statement published by the then Director of the Division of Mental Health.*
In ICD-10, `Fatigue Syndrome’ is classified as an inclusion term under F48.0. Neurasthenia. `Postviral fatigue’ is excluded from this category and should be classified as G93.3. This latter category mentions `benign myalgic encephalitis [sic]’ as an inclusion term.
“ Although in clinical practice it is often very difficult to determine the role of viral infections in chronic fatigue, and although scientifically the need for two separate categories is not well established, these have been adopted for ICD-10 because of varying recording practices. It is to be hoped that the issue of the classification of fatigue syndrome will be resolved through research in the coming years, so that adjustments can be made in ICD-11, if necessary.
“ In the meantime the following rules are recommended for the coding of `fatigue syndrome’ according to ICD-10:
“ Category F48.0 Neurasthenia [fatigue syndrome] should be used for all patients fulfilling the criteria for this disorder. If the neurasthenic syndrome develops in the aftermath of a physical disease (in particular influenza, viral hepatitis or infectious mononucleosis), the diagnosis of the latter should also be recorded.
“ Category G93.3 Postviral fatigue syndrome should be used for conditions with excessive fatigue, following a viral disease, that do not fulfil the criteria for F48.0 or where no further clinical evaluation as to these criteria are performed.”
“ The use of the term `benign myalgic encephalomyelitis’ should be avoided, until the status of this condition has been clarified.”
We have checked extensively and are sure that this statement from WHO has not be superceded by any more recent statement.
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*Note, I don't think this
"statement published by the then Director of the [WHO] Division of Mental Health" from which Ms Paton quoted, in 2001, was a public domain statement and it's not known which former Director of the [WHO] Division of Mental Health had originally issued the statement, in which year, for what purpose or to whom.
But the statement may have possibly originated from Norman Sartorius, a former WHO Director of the Division of Mental Health and a former president of the World Psychiatric Association and of the European Psychiatric Association. His tenure as Director of Division of Mental Health would fit with the timeline.
Edited to add: Note also that Prof, Sir David Goldberg (Professor Emeritus, Institute of Psychiatry, King's College London - which is a WHO Collaborating Centre) and a co-author of the "Reattribution Model" for somatoform disorders, had a long collaboration association with Norman Sartorius and the WHO's Bedirhan Ustun.
Goldberg had chaired the working group for the development of the WHO's
ICD–10 Primary Health Care (PHC) diagnostic and management guidelines for mental disorders and was part of the working group for the Institute of Psychiatry's print adaptation of this WHO publication for UK use, for which errata slips had to be inserted, after the book had been printed, to correct errors around ICD coding that had been introduced by the Institute of Psychiatry and corrections made to the IOP's website pages based on this adaptation.
