The main reason for the very different conclusions which Noreen Buckley (How we can help ME sufferers in north Essex, Letters, Gazette, June 23), and I, a research psychologist and veteran ME sufferer of 21 years, come to about the treatments available for people with ME (Myalgic Encephalomyelitis) is that we are each talking about a different population of patients.

Despite our diametrically opposed advice about the management techniques available at her clinic and the other 11 around the UK, we are as one in hoping that continued public debate will help provide an informed conclusion.

Noreen is quite correct that ME is more commonly referred to as Chronic Fatigue Syndrome, but it ought not to be, firstly, because the omnipresent lack of stamina in ME is not like fatigue as we normally understand it. It does not come on, as tiredness usually does, with physical or mental effort, nor is it refreshed by any amount of sleep, and there is a range of symptoms including tender, swollen glands, low-grade fever, cognitive dysfunction and dizziness which the word fatigue does not cover.

Secondly, Chronic Fatigue Syndrome is not a single, discrete, neurological illness, as ME is. It is a catch-all diagnostic basket for a variety of illnesses.

In fact, CFS is so loose a diagnostic label, it is hard to think of any illness which could not fit CFS.

Bundling ME with these other illnesses causes a domino effect of poor experimental design and research practices, resulting in invalid and unreliable conclusions being drawn.

There is no centralised, structure for analysing any statistics gathered nationally.

Multidisciplinary teams give treatments in different combinations and over different periods of time to people said to have ME but are judged by different criteria.

There are too many indefinites because of experimental design and lack of follow-up.

It is extraordinary that, despite all the evidence showing that Cognitive Behaviour Therapy is of no lasting benefit, and Graded Exercise Treatment makes a majority worse, they remain the recommended treatments for ME sufferers.

p>Dr John H Greensmith
ME Free For All. org
North Street
Downend, Bristol