Petition Update July 13th 2025

The latest edition of Kumar and Clark’s Clinical Medicine (11th edition) was released on June 16th 2025.  

The petition seems to have had an effect  Petition · ME/CFS: Changing the Definition - United Kingdom · Change.org  because their description of ME/CFS isn’t the usual copy and paste job from edition to edition.

Sadly, though, ME/CFS has been placed in the ‘General hospital psychiatry’ chapter, more specifically under ‘MUS’ (Medically Unexplained Symptoms) and ‘FND’ (Functional Neurological Disorder).

The best change has been the withdrawal of promoting Graded Exercise Therapy. The previous edition promoted GET as a treatment for ‘CFS’.

Another positive breakthrough is the inclusion of the WHO’s classification of ME/CFS as ‘Diseases of the nervous system’.  This wasn’t mentioned in the previous edition.

Also, M.E. is actually mentioned in this latest edition (under Myalgic Encephalopathy) whereas last time it was omitted completely from the section under CFS.

However, the recent publication of Kumar and Clark still places M.E. sufferers in danger. The PACE Trial is being promoted as further reading. In addition, there are still derogatory character accusations towards sufferers, stating that they should accept a psychological element to their illness. The patient is blamed in the book for lack of recovery if they are not positive about the treatment offered. The treatment promoted in the book is: CBT, psychosocial interventions (e.g. pragmatic active rehabilitation programmes) and drug therapies (e.g. antidepressant medications).

Although M.E. is actually included in the book (not just CFS), it is harmful that M.E. is seen in the psychiatry section.

We have requested an erratum for Elsevier to correct changes in their recent book.

                                                       Erratum Request                                                                                                                July 3rd 2025

Dear Elsevier,

The undersigned request an erratum [1] to the recently published 11th edition of Kumar and Clark’s Clinical Medicine.

The pages we refer to are 1029 and 1030, under ‘Medically Unexplained Symptoms and Functional Neurological Disorders’ within Chapter 30 ‘General hospital psychiatry’.  The illness for which we are requesting an erratum is written as ‘Chronic fatigue syndrome/myalgic encephalopathy.’

1) We request an erratum to acknowledge that ME/CFS should not appear under 'general hospital psychiatry' but under 'Neurology', and a commitment to update online or e-book chapter placement and future published editions.  The WHO lists ME/CFS alongside Multiple Sclerosis within Chapter 8 ‘Diseases of the Nervous System’. 

2) The term Myalgic Encephalopathy should be corrected to Myalgic Encephalomyelitis as it appears in the scientific literature and World Health Organisation (WHO) classification. [2]

3) We request a withdrawal of the claim that ME/CFS is in part psychological. [3] [4]

4) The PACE Trial has been discredited [5] and therefore should be removed from ‘Further reading’. It also promotes Graded Exercise Therapy which NICE no longer recommends for ME/CFS sufferers due to patient harms. [6]

We look forward to working with Elsevier on these changes.

Yours sincerely, 

Mrs. Catherine Ashenfelter, The Grace Charity for M.E. (registered charity 1117058) 

Petition · ME/CFS: Changing the Definition - United Kingdom · Change.org

Co-signatories of this erratum request:

The 25% ME Group (registered charity SC034265)

Tymes Trust (registered charity 1080985)

The ME Association (registered charity 801279)

Dr. Nina Muirhead, medical educator, creator of online learning module on ME/CFS

ME Action UK (registered charity 1202130)

[1]Errata and corrigenda | Editors | Elsevier

[2] ICD-11 for Mortality and Morbidity Statistics  

[3] Article withdrawal | Elsevier policy

[4] Myalgic encephalomyelitis/chronic fatigue syndrome and the biopsychosocial model: a review of patient harm  and distress in the medical encounter - PubMed

[5] PACE team response shows a disregard for the principles of science - Jonathan Edwards, 2017

[6] Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE Box 4 1.11.14