Simon Wessely
Sir Simon Charles Wessely is a British psychiatrist. He is Regius Professor of Psychiatry at the Institute of Psychiatry, King's College London 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 and the Maudsley Hospital, as well as civilian consultant advisor in psychiatry to the British Army. He was knighted in the 2013 New Year Honours for services to military healthcare and to psychological medicine. From 2014 to 2017, he was the elected president of the Royal College of Psychiatrists and then became the first psychiatrist to be elected as President of the Royal Society of Medicine in 200 years.
He became Britain's first and only Regius Professor of Psychiatry in 2018, and joined the board of NHS-England in 2023.
Training
After attending King Edward VII School in Sheffield from 1968 to 1975, Wessely studied at Trinity Hall, Cambridge, University College, Oxford, and the London School of Hygiene and Tropical Medicine. In 1993 the University of London conferred upon him the degree of Doctor of Medicine.Wessely completed a medical rotation in Newcastle. After attaining medical membership he studied psychiatry 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. In 1999 he was elected fellow of the UK Academy of Medical Sciences.
Research
Wessely's 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 900 papers. His first interest was in medically unexplained symptoms and syndromes, most often about chronic fatigue syndrome, including its aetiology, history, psychology, immunology, sociology, epidemiology and treatment. Later he moved into military health, publishing on numerous areas including combat stress, post traumatic stress, mental health screening, tour length, shell shock, Gulf War syndrome, Forces Health Protection, veterans' mental and physical health, substance misuse, stigma, impact of deployment, families, children of military families, reservists, cohesion and morale, concussion and head injury, combat motivation, peer support, moral injury, peacekeeping, violence, women in combat roles, and military history.Other interests include epidemiology, medicine and law, history of psychiatry, chronic pain, somatisation, chemical and biological terrorism and deliberate self-harm.
He has over 1000 papers with an H index of 153 and his work has been cited in over 118, 000 scientific papers In 2021 he became a 'Highly Cited Researcher", putting him in the top 0.1% of science and social science researchers.
Work on chronic fatigue syndrome
In the first years after the introduction of the diagnosis chronic fatigue syndrome 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 inaccurate, 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 issue. Other work on CFS included the development of new measurement tools, establishing the lack of relationship between hyperventilation and CFS, discovery of an endocrine "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, using randomised controlled trials and follow-up studies, developed a rehabilitation strategy for patients that involved cognitive behavioural and graded exercise therapy, that was claimed to be effective in reducing symptoms of CFS in ambulant patients. 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 work includes a history of CFS, numerous reviews, and co-authoring the 1998 book Chronic fatigue and its syndromes.
Wessely believes that CFS generally has some organic trigger, such as a virus, but that the role of psychological and social factors are more important in perpetuating the illness, otherwise known as the 'cognitive behavioural model' of CFS, and that treatments centred around these factors can be effective. He describes the cognitive behavioural model as follows: "According to the model the symptoms and disability of CFS are perpetuated predominantly by dysfunctional illness beliefs and coping behaviours. These beliefs and behaviours interact with the patient's emotional and physiological state and interpersonal situation to form self-perpetuating vicious circles of fatigue and disability... The patient is encouraged to think of the illness as 'real but reversible by his or her own efforts' rather than as a fixed unalterable disease". A 2019 review found that the cognitive behavioral model of CFS underpinning the promotion of CBT lacks high-quality evidential support and that "There is little scientific credibility in the claim that psycho-behavioural therapies are a primary treatment for this illness."
In 2009, a paper was published in Science stating that the XMRV virus was found in two-thirds of CFS patients. Wessely collaborated with experts in retrovirology at Imperial College London, sharing with them stored DNA samples from the King's CFS unit, and providing the first proof that XMRV was not the cause of CFS/ME. Wessely also said that this research fails to model the role that childhood abuse, psychological factors, and other infections may play in the illness. The Science paper was retracted but not before there was intense criticism of the King's/Imperial failure to replicate, claiming that the patients seen at King's did not have CFS/ME. The team responded showing this to be unfair.
Opposition and criticism
In an interview published by The Lancet, Wessely discusses the controversy relating to his work on Gulf War syndrome and chronic fatigue syndrome. He stated that, in hindsight, he was keen to get published and could have been more diplomatic and admits he is now better at handling controversy. He has been described as both "the most hated doctor in Britain" and "one of the most respected psychiatrists working in Britain today".Malcolm Hooper, the Countess of Mar, and others have strongly criticised Wessely including specific allegations which he said are myths. In a 2002 article on chronic fatigue syndrome, The Guardian characterised the criticisms of one group of patients as a "vendetta." Wessely has repeatedly stated he has been the subject of numerous threats and personal attacks, and that "militants" have even made threats to his life. "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 research into CFS around 2001, and as of 2011 his clinical work was with members of the armed forces; he said: "I now go to Iraq and Afghanistan, where I feel a lot safer".
Military health
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. Their work found an association between both multiple vaccines and vaccines used to protect against biological warfare. His group also confirmed that classic psychiatric injury 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 did not find evidence that exposure to organophosphate agents had caused chronic neurological damage, nor evidence linking depleted uranium to Gulf War Illness. The group also showed that although many veterans, irrespective of service in the 1991 Gulf War, who left the Armed Forces with persisting mental health problems did seek and receive help for mental health problems, a substantial minority did notWhile this work, Wessely's evidence to the Lloyd Inquiry, and the work of other investigators was crucial in categorising Gulf War syndrome as a verifiable consequence of service in the Gulf, which resulted in affected Gulf War veterans being able to receive war pensions, Wessely does not believe that Gulf War syndrome exists as a distinct illness, stating "Is there a problem? Yes there is. Is it Gulf War syndrome or isn't it? I think that's a statistical and technical question that's of minor interest." His and many other groups failed to show the existence of a discrete syndrome related to Gulf War service, as a result of which he prefers the term "Gulf War Illnesses" or "Gulf War health effects", which might have at least in part being triggered by stress, specifically troops' anxiety about chemical weapons and vaccines, as well as misinformation about Gulf War syndrome.
In 1998 Wessely co-founded the King's Centre for Military Health with social scientist Professor Christopher Dandeker. Following the 2003 invasion of Iraq, and mindful of the problems that had arisen with Gulf War Illnesses, they began a new long term study of the possible impact of this new deployment on the health and well being of UK Armed Forces deployed to Iraq. This study has continued to the present day, and is the main source of information on the short, medium and long term effects of the deployment to Iraq.
Early results showed that there had been no "Iraq War Syndrome", despite the fact that the Forces had received similar drugs and vaccinations to protect against chemical and biological warfare. Improvements in record keeping now showed that both anthrax and multiple vaccinations were not associated with medium or long term ill health. KCMHR did not find an early and anticipated "tidal wave" or "tsumani" of PTSD in Regulars post deployment, but did show that reservists experienced more frequent and prolonged ill health that Regulars. As a consequence of this MOD created a new specific mental health programme for reservists. However, by 10 and then 20 years, PTSD rates had increased overall, with the greatest increase in those who had been in direct combat roles, and had now left the Services.
KCMHR, has become a leading centres in military health research globally. In two recent citation analyses Wessely was rated the most published author on military health, with his colleagues Professors Fear and Greenberg in third and fourth place globally.