Had things gone as planned, the PACE trial should have been able to serve as proof that so-called medically unexplained symptoms (MUS)—in this case what the investigators referred to as chronic fatigue syndrome–could be successfully treated with psychological and behavioral therapies.
The Lancet published the first PACE results, which reported benefits from cognitive behavioural therapy and graded exercise therapy, in early 2011. The timing dovetailed with the National Health Service’s expansion of a program called
Improving Access to Psychological Therapies (IAPT).
Launched in England in 2008 to increase links between medical care and mental health services for those identified as suffering from depression and anxiety disorders, IAPT’s mandate next expanded to include other groups of patients, specifically those suffering from either long-term conditions, such as cancer, and from conditions identified as part of the MUS category. Many academic promoters of IAPT are colleagues of key PACE investigators. They are also fellow proponents of the CBT/GET paradigm for the illness, or cluster of illnesses, variously referred to as CFS, myalgic encephomyelitis, ME/CFS and CFS/ME.
Unfortunately for these folks, many segments of the international scientific community have rejected the PACE findings after public debate over the trial’s many documented missteps............
