Rosemary Underhill

Rosemary A. Underhill, MB. B.S. (1937-2021) also known as Rosemary Underhill O'Gorman, was a Physician Consultant and a Fellow of Royal College of Surgeons. Underhill trained as a physician, a surgeon and an obstetrician in London, England and was a medical student when she witnessed the Royal Free Hospital outbreak in 1955.

Dr. Underhill was a consultant and member of the board of Trustees of the New Jersey ME/CFS Association for many years. Dr Underhill died in 2021.

School phobia / school refusal

Dr Underhill highlighted the misdiagnosis of ME/CFS in children as a mental disorder or parental problem:

"ME/CFS has often been misdiagnosed, as School Avoidance Behavior, or as Munchausen's syndrome by proxy (a condition in which, a parent fabricates their child's illness)."

See also

School phobia.

2017 Pediatric Primer

Dr. Underhill was one of the authors of the 2017 Pediatric Primer published in Frontiers in Pediatrics.

• Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer by Peter C. Rowe, Rosemary A. Underhill, Kenneth J. Friedman, Alan Gurwitt, Marvin S. Medow, Malcolm S. Schwartz, Nigel Speight, Julian M. Stewart, Rosamund Vallings and Katherine S. Rowe (Full Text)

2021 Royal Free outbreak follow-up

In 2021, fifty-eight years after the Royal Free Hospital outbreak of myalgic encephalomyelitis, Underhill and Baillod interviewed former hospital staff, including some who developed ME. They found that the former staff's description of the patients was inconsistent with McEvedy and Beard's hypothesis that the illness was psychosomatic, i.e., physical illness caused by mass hysteria or psychoneurosis. The former staff described clear objective signs that the cause of illness was physical in origin, and stated that most staff at the time believed it was the result of an infectious disease.

Books

• 2002, Dr. Underhill was on the writing committee for A Consensus Manual for the Primary Care and Management of Chronic Fatigue Syndrome, Joseph F. John, Jr., MD, Editor and James M. Oleske, MD, MPH, Associate Editor.

Hypothesis on the disease ME/CFS

Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease - Medical Hypotheses December 2015 Volume 85, Issue 6, Pages 765–773

Clinical guides

• Chronic Fatigue Syndrome/Myalgic Encephalomyelitis - Primer for Clinical Practitioners 2014 Edition IACFS/ME (Co-author.)

• A Consensus Manual for the Primary Care and Management of Chronic Fatigue Syndrome The Academy of Medicine of New Jersey and the New Jersey Department of Health and Senior Services. (Writing committee member.)

Notable articles

• 2021, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Organic Disease or Psychosomatic Illness? A Re-Examination of the Royal Free Epidemic of 1955 (Full text)
• 2007, Chronic Fatigue Syndrome in Children and Adolescents - (Full text)
• 2006, Prevalence of Chronic Fatigue Syndrome and Chronic Fatigue Within Families of CFS Patients - (Abstract)

Open letter to The Lancet

Two open letters to the editor of The Lancet urged the editor to commission a fully independent review of the PACE trial, which the journal had published in 2011. In 2016, Dr. Underhill, along with 41 colleagues in the ME/CFS field, signed the second letter.

• 10 February 2016, An open letter to The Lancet, again - Virology blog

CFSAC testimony

• October 2012 Public Comment to CFSAC - "Suggested protocol for investigating cluster outbreaks of ME/CFS"

See also

• Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer
• Open letter to the Lancet
• Royal Free Hospital outbreak
• New Jersey ME/CFS Association

Learn more

• Obituary - 2021

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

somatic symptom disorder A psychiatric term to describe an alleged condition whereby a person's thoughts somehow cause physical symptoms. The actual existence of such a condition is highly controversial, due to a lack of scientific evidence. It is related to other psychiatric terms, such as "psychosomatic", "neurasthenia", and "hysteria". Older terms include "somatization", "somatoform disorder", and "conversion disorder". Such terms refer to a scientifically-unsupported theory that claims that a wide range of physical symptoms can be created by the human mind, a theory which has been criticized as "mind over matter" parapsychology, a pseudoscience.

somatic symptom disorder A psychiatric term to describe an alleged condition whereby a person's thoughts somehow cause physical symptoms. The actual existence of such a condition is highly controversial, due to a lack of scientific evidence. It is related to other psychiatric terms, such as "psychosomatic", "neurasthenia", and "hysteria". Older terms include "somatization", "somatoform disorder", and "conversion disorder". Such terms refer to a scientifically-unsupported theory that claims that a wide range of physical symptoms can be created by the human mind, a theory which has been criticized as "mind over matter" parapsychology, a pseudoscience.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

Chronic Fatigue Syndrome Advisory Committee (CFSAC) - (sometimes pronounced SIF-SACK) A US government advisory council that met twice per year, covering current topics related to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Meetings usually lasted for two days and the results were presented to the Secretary of Health and Human Services (HHS). After 15 years, on September 5, 2018, CFSAC's charter was not renewed by the Department of HHS, effectively dissolving the committee without notice or warning.