Simon Wessely
Encyclopedia
Simon Wessely is a British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

. He is professor of epidemiological
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

 and liaison psychiatry
Liaison psychiatry
Liaison psychiatry, also known as consultative psychiatry or consultation-liaison psychiatry is the branch of psychiatry that specialises in the interface between medicine and psychiatry, usually taking place in a hospital or medical setting...

 at the Institute of Psychiatry
Institute of Psychiatry
The Institute of Psychiatry is a research institution dedicated to discovering what causes mental illness and diseases of the brain. In addition, its aim is to help identify new treatments for them and ways to prevent them in the first place...

, King's College London
King's College London
King's College London is a public research university located in London, United Kingdom and a constituent college of the federal University of London. King's has a claim to being the third oldest university in England, having been founded by King George IV and the Duke of Wellington in 1829, and...

 and Head of its department of psychological medicine, Vice Dean for Academic Psychiatry, Teaching and Training at the Institute of Psychiatry, as well as Director of the King's Centre for Military Health Research. He is also honorary Consultant Psychiatrist at King's College Hospital
King's College Hospital
King's College Hospital is an acute care facility in the London Borough of Lambeth, referred to locally and by staff simply as "King's" or abbreviated internally to "KCH"...

 and Maudsley Hospital
Maudsley Hospital
The Maudsley Hospital is a British psychiatric hospital in South London. The Maudsley is the largest mental health training institution in the country...

, as well as Civilian Consultant Advisor in Psychiatry to the British Army
British Army
The British Army is the land warfare branch of Her Majesty's Armed Forces in the United Kingdom. It came into being with the unification of the Kingdom of England and Scotland into the Kingdom of Great Britain in 1707. The new British Army incorporated Regiments that had already existed in England...

.

Training and interests

After attending King Edward VII School
King Edward VII School (Sheffield)
King Edward VII School is a secondary school and language college located in Sheffield, South Yorkshire, England. KES, named after the reigning monarch, was formed in 1905 when Wesley College was merged with Sheffield Royal Grammar School on the site of the former on Glossop Road...

 in Sheffield
Sheffield
Sheffield is a city and metropolitan borough of South Yorkshire, England. Its name derives from the River Sheaf, which runs through the city. Historically a part of the West Riding of Yorkshire, and with some of its southern suburbs annexed from Derbyshire, the city has grown from its largely...

 from 1968 to 1975, Wessely studied at Trinity Hall, Cambridge
Trinity Hall, Cambridge
Trinity Hall is a constituent college of the University of Cambridge, England. It is the fifth-oldest college of the university, having been founded in 1350 by William Bateman, Bishop of Norwich.- Foundation :...

 (BA
Bachelor of Arts
A Bachelor of Arts , from the Latin artium baccalaureus, is a bachelor's degree awarded for an undergraduate course or program in either the liberal arts, the sciences, or both...

 1978), University College, Oxford
University College, Oxford
.University College , is a constituent college of the University of Oxford in England. As of 2009 the college had an estimated financial endowment of £110m...

 (BM BCh
Bachelor of Medicine and Surgery
Bachelor of Medicine, Bachelor of Surgery, or in Latin Medicinae Baccalaureus, Baccalaureus Chirurgiae , are the two first professional degrees awarded upon graduation from medical school in medicine and surgery by universities in various countries...

 1981), and the London School of Hygiene and Tropical Medicine (MSc
Master of Science
A Master of Science is a postgraduate academic master's degree awarded by universities in many countries. The degree is typically studied for in the sciences including the social sciences.-Brazil, Argentina and Uruguay:...

 1989). In 1993 the University of London
University of London
-20th century:Shortly after 6 Burlington Gardens was vacated, the University went through a period of rapid expansion. Bedford College, Royal Holloway and the London School of Economics all joined in 1900, Regent's Park College, which had affiliated in 1841 became an official divinity school of the...

 conferred upon him the degree of Doctor of Medicine
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

.

Wessely completed a medical rotation in Newcastle. After attaining medical membership
Membership of the Royal College of Physicians
Membership of the Royal Colleges of Physicians is a postgraduate medical diploma. The examinations are run by the Federation of the Medical Royal Colleges of the United Kingdom – the Royal College of Physicians of London, the Royal College of Physicians of Edinburgh, and the Royal College...

 he studied psychiatry (his primary interest) at the Maudsley in 1984. His 1993 doctoral thesis was on the relationship between crime
Crime
Crime is the breach of rules or laws for which some governing authority can ultimately prescribe a conviction...

 and schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

. Post-doctoral studies included a year at the National Hospital for Neurology and Neurosurgery
National Hospital for Neurology and Neurosurgery
The National Hospital for Neurology and Neurosurgery is a neurological hospital in London, United Kingdom and part of the University College London Hospitals NHS Foundation Trust...

 and a year studying epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

 at the London School of Hygiene and Tropical Medicine. In 1999 he was elected fellow of the U.K. Academy of Medical Sciences
Academy of Medical Sciences
The Academy of Medical Sciences is the United Kingdom's national academy of medical sciences. It was established in 1998 on the recommendation of a group that was chaired by Michael Atiyah. Its president is John Irving Bell....

 (FMedSci).

Wessely's main research interests lie in the "grey areas" between medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...

 and psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

, clinical epidemiology and military health. His first paper was entitled "Dementia and Mrs. Thatcher", since then he has published over 600 papers on subjects including epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

, post traumatic stress, medicine and law, history of psychiatry, chronic pain
Chronic pain
Chronic pain has several different meanings in medicine. Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time from onset; the two most commonly used markers being 3 months and 6 months since the initiation of pain, though some theorists and...

, somatisation
Somatization disorder
Somatization disorder is a psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms that have no identifiable physical origin...

, Gulf War illness, chemical and biological terrorism
Terrorism
Terrorism is the systematic use of terror, especially as a means of coercion. In the international community, however, terrorism has no universally agreed, legally binding, criminal law definition...

 and deliberate self harm. He has published most widely on aspects of chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...

, including its aetiology, history, psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

, immunology
Immunology
Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders ; the...

, sociology
Sociology
Sociology is the study of society. It is a social science—a term with which it is sometimes synonymous—which uses various methods of empirical investigation and critical analysis to develop a body of knowledge about human social activity...

, epidemiology and treatment.

In private life, Wessely is married and has two sons. His interests include skiing
Skiing
Skiing is a recreational activity using skis as equipment for traveling over snow. Skis are used in conjunction with boots that connect to the ski with use of a binding....

 and history
History
History is the discovery, collection, organization, and presentation of information about past events. History can also mean the period of time after writing was invented. Scholars who write about history are called historians...

, and he has cycled from London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

 to Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...

 in 2006 and again in 2007, to raise money for veterans' charities.

Work on chronic fatigue syndrome

In the first years after the introduction of the diagnosis chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...

 the condition was often mocked in the media, for example being described as "yuppie flu". Wessely and his co-workers verified that this stereotype was a misnomer, substantiating an association between autonomic dysfunction and chronic fatigue syndrome and providing reliable data on the prevalence of CFS in the community, showing that it has become an important public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...

 issue. Other work on CFS included the development of new measurement tools, establishing the lack of relationship between hyperventilation
Hyperventilation
Hyperventilation or overbreathing is the state of breathing faster or deeper than normal, causing excessive expulsion of circulating carbon dioxide. It can result from a psychological state such as a panic attack, from a physiological condition such as metabolic acidosis, can be brought about by...

 and CFS, discovery of an endocrine
Endocrine system
In physiology, the endocrine system is a system of glands, each of which secretes a type of hormone directly into the bloodstream to regulate the body. The endocrine system is in contrast to the exocrine system, which secretes its chemicals using ducts. It derives from the Greek words "endo"...

 "signature" for CFS that differed from depression and that prior depressive illnesses were likely linked to the condition in some cases.

Wessely and his colleagues also developed a rehabilitation strategy for patients that involved cognitive behavioral and graded exercise therapy
Graded exercise therapy
Graded exercise therapy is physical activity that starts very slowly and gradually increases over time. This approach is used as part of a treatment plan for chronic fatigue syndrome and certain other conditions...

; research using randomised controlled trials
Randomized controlled trial
A randomized controlled trial is a type of scientific experiment - a form of clinical trial - most commonly used in testing the safety and efficacy or effectiveness of healthcare services or health technologies A randomized controlled trial (RCT) is a type of scientific experiment - a form of...

 and follow-up studies, which have been demonstrated as effective at reducing symptoms of the condition in ambulant (non-severely affected) patients, which otherwise lacks a cure or unequivocally successful treatment. Other studies looked at the professional and popular views of CFS, neuropsychological impairment in CFS, and cytokine activation in the illness. Some of his other written works include a history of CFS, numerous reviews and co-authoring the 1998 book Chronic fatigue and its syndromes. He has also established the first National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

 programme solely devoted to patients with CFS, and continues to provide ongoing treatment with patients at King's College Hospital.

Wessely believes that CFS generally has some organic trigger, such as a virus
Virus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...

, but that the role of psychological and social factors are more important in perpetuating the illness and treatments centred around these factors can be effective. He sees viral attribution in CFS as 'somatisation par excellence'. In a BMJ interview, Wessely indicated that the cause of CFS onset is irrelevant to management of the condition, and he would not treat viruses in CFS patients even if detected, because he is "in the business of rehabilitation". Commenting on a study that stated XMRV virus was found in two thirds of CFS patients, Wessely said this research fails to model the role childhood abuse, psychological factors, and other infections may play in the illness.

For his work on CFS, he has been awarded a medal by the Royal College of Physicians
Royal College of Physicians
The Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...

.

Opposition and criticism

In an interview published by The Lancet, Wessely admits to both regretting and enjoying the controversy relating to his work on Gulf War syndrome and chronic fatigue syndrome. With hindsight he states that he was keen to get published, could have been more diplomatic, and is now better at handling controversy. The Times
The Times
The Times is a British daily national newspaper, first published in London in 1785 under the title The Daily Universal Register . The Times and its sister paper The Sunday Times are published by Times Newspapers Limited, a subsidiary since 1981 of News International...

 of 6 August 2011 described him as "the most hated doctor in Britain", noting that this does not originate with his peers or patients; "Curiously, most of the people who hate Professor Wessely have never met him. But over the past two decades they have followed his work from afar, mostly over the internet and what has been written, or — sometimes incorrectly — implied, about him in the papers."

Although Wessely has studied physical markers and allows the possibility of a biological basis to CFS, he is not confident of such a basis and remains sceptical. He has also gone on to accuse patients of having "an overwhelming desire to get rid of the psychiatrists" from the area of chronic fatigue syndrome. When asked about severely affected bed-ridden patients, Wessely said "in that kind of disability, psychological factors are important and I don't care how unpopular that statement makes me."

Some CFS patient activist groups have strongly criticized Wessely, while extremists have gone to the extent of threatening his life. In an article on chronic fatigue syndrome, The Guardian calls criticism from CFS patient advocates a "vendetta". Wessely has been the subject of numerous threats and personal attacks. "It is a relentless, vicious, vile campaign designed to hurt and intimidate...For some years now all my mail has been x rayed. I have speed dial phones and panic buttons at police request and receive a regular briefing on my safety and specific threats." Wessely gave up active research into CFS 10 years ago and now specialises in working with war veterans. "I now go to Iraq and Afghanistan, where I feel a lot safer".

Military health

More recently, Wessely's work was the first to show that service in the 1991 Gulf War
Gulf War
The Persian Gulf War , commonly referred to as simply the Gulf War, was a war waged by a U.N.-authorized coalition force from 34 nations led by the United States, against Iraq in response to Iraq's invasion and annexation of Kuwait.The war is also known under other names, such as the First Gulf...

 had had a significant effect on the health of UK servicemen and women. Other work suggested a link to particular vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

 schedules used to protect against biological warfare
Biological warfare
Biological warfare is the use of biological toxins or infectious agents such as bacteria, viruses, and fungi with intent to kill or incapacitate humans, animals or plants as an act of war...

, and also a link with psychological stress. His group also confirmed that classic psychiatric injury, post-traumatic stress disorder
Post-traumatic stress disorder
Posttraumaticstress disorder is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,...

 (PTSD), was not a sufficient explanation for the observed health problems. He and his colleagues in the medical school showed persisting evidence of immune
Immune system
An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...

 activation, but failed to show that exposure to organophosphate
Organophosphate
An organophosphate is the general name for esters of phosphoric acid. Phosphates are probably the most pervasive organophosphorus compounds. Many of the most important biochemicals are organophosphates, including DNA and RNA as well as many cofactors that are essential for life...

 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
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...

 problems have found it difficult to access National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

 (NHS) services.

This work, Wessely's evidence to the Lloyd Inquiry, and the work of other investigators was crucial in categorising Gulf War Syndrome
Gulf War syndrome
Gulf War syndrome or Gulf War illness describes a medical condition that affected veterans and civilians who were near conflicts during or downwind of chemical weapons depot demolition, after the 1991 Gulf War. A wide range of acute and chronic symptoms have included fatigue, musculoskeletal...

 as a verifiable consequence of service in the Gulf. 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
Iraq
Iraq ; officially the Republic of Iraq is a country in Western Asia spanning most of the northwestern end of the Zagros mountain range, the eastern part of the Syrian Desert and the northern part of the Arabian Desert....

. The results were published in the medical journal The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...

.

Other interests

Wessely also has a long standing interest in how normal people react to adversity, and what, if any, responses are appropriate. He was a co-author of an influential Cochrane Review
Cochrane Library
The Cochrane Library is a collection of databases in medicine and other healthcare specialties provided by the Cochrane Collaboration and other organisations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the...

 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
The Blitz
The Blitz was the sustained strategic bombing of Britain by Nazi Germany between 7 September 1940 and 10 May 1941, during the Second World War. The city of London was bombed by the Luftwaffe for 76 consecutive nights and many towns and cities across the country followed...

, and latterly an early study of reactions to the July 7, 2005 London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

 bombings.

In many venues, he has argued that people are more resilient
Psychological resilience
Resilience in psychology refers to the idea of an individual's tendency to cope with stress and adversity. This coping may result in the individual “bouncing back” to a previous state of normal functioning, or using the experience of exposure to adversity to produce a “steeling effect” and function...

 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.

External links

  • Official homepage
  • KCL.ac.uk - The King's Centre For Military Health Research (KCMHR) is a joint initiative of the Institute of Psychiatry and the Department of War Studies at King's College London (Wessely's webpage at King's College)
  • KCL.ac.uk - "Health & Wellbeing of UK Armed Forces Personnel: Professor Simon Wessely - Principal Investigator", KCMHR
  • 'Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome', lecture given at Gresham College
    Gresham College
    Gresham College is an institution of higher learning located at Barnard's Inn Hall off Holborn in central London, England. It was founded in 1597 under the will of Sir Thomas Gresham and today it hosts over 140 free public lectures every year within the City of London.-History:Sir Thomas Gresham,...

    , 25 January 2006 (available in text, audio and video formats)
  • NATO.int - 'NATO-Russia Advanced Research Workshop on Social and Psychological Consequences of Chemical, Biological, and Radiological Terrorism', Simon Wessely, North Atlantic Treaty Organization (March 25–27, 2002)
  • Project-Syndicate.org - 'The Trouble with Treating Trauma', Simon Wessely (August, 2003)
  • 'Shell Shock or Cowardice? - The case of Harry Farr', lecture given at Gresham College
    Gresham College
    Gresham College is an institution of higher learning located at Barnard's Inn Hall off Holborn in central London, England. It was founded in 1597 under the will of Sir Thomas Gresham and today it hosts over 140 free public lectures every year within the City of London.-History:Sir Thomas Gresham,...

    , 1 October 2008 (available in text, audio and video formats)
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