Simon Wessely

Simon Wessely is a British psychiatrist. He is professor of epidemiological and liaison psychiatry at the Institute of Psychiatry, King's College London and head of its department of psychological medicine, 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 Maudsley Hospital, as well as Civilian Consultant Advisor in Psychiatry to the British Army.

Training and interests
After attending King Edward VII School in Sheffield from 1968 to 1975, Wessely trained at Cambridge (where he also read arts) and Oxford Universities, with 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.

His 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", since then he has published over 500 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. .

In private life, he is married with two sons. His interests include skiing and history, and he has cycled from London to Paris in 2006 and again in 2007, to raise money for veterans' charities.

Work on CFS/ME
In the early days of recognition of chronic fatigue syndrome (also known as myalgic encephalomyelitis), it was often played down in the media, for example being described as "yuppie flu".

Wessely and his co-workers established that this stereotype was a misnomer, demonstrating an association between low blood pressure and chronic fatigue and providing reliable data on the prevalence of CFS in the community, showing that it has become an important public health issue. They developed new measurement tools, established that hyperventilation was not a risk factor for the illness (but that prior depressive illnesses were), found a particular endocrine "signature" for CFS that differed from depression, and developed a new rehabilitation strategy for patients. The value of such intervention was later confirmed in a series of randomised controlled trials and follow-up studies. Other studies looked at stigma and CFS, neuropsychological impairment in CFS, and more recently reported cytokine activation in the illness. He has also traced its historical origins.

Wessely's work suggests CFS is generally consequent from some organic trigger, such as a virus, but that the role of psychological, physiological and social factors should also be considered when considering failure of some patients to recover - and that treatments centred around these factors can be effective in many cases. However, his claims in this area are criticised by some other health and academic professionals, and by many patient advocates.

He set up the first National Health Service (NHS) programme solely devoted to patients with CFS, and continues to see sufferers regularly at King's College Hospital. He has also been awarded a medal by the Royal College of Physicians for his work on CFS. In 1999 he was elected fellow of the U.K. Academy of Medical Sciences (FMedSci).

Wessely's summarised his view on CFS in a 2003 review article, co-authored with Baruch Fischhoff and published in the British Medical Journal. He has also co-authored the 1998 book "Chronic Fatigue and its Syndromes".

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.

This work, and Wessely's evidence to the Lloyd Inquiry, was crucial in categorising Gulf War Syndrome as a verifiable consequence of service in the Gulf, and as a result affected Gulf War veterans were able to receive war pensions.

He recently spent a sabbatical in the Department of War Studies at King's College London.

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. .

Other interests
Wessely also has a long standing interest in how normal people react to adversity, and what, if anything, should be our responses. 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. 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.

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. 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.

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

Opposition and criticism
Areas of Wessely's work have been the subject of criticism, largely from patients' groups. These critics hold him responsible for promulgating the view that chronic fatigue syndrome is primarily a psychiatric condition, an approach termed the "psychiatric paradigm" by opponents. Wessely counters that few deny a potential physical mechanism, but that the effects are mainly functional; research conducted under his direction has detected markers of physical abnormalities in CFS.