The working group's report, published in 1996, agreed with the Task Force as to the importance of the condition, and as to the likely multifactorial nature of the underlying causes. It felt, like the Task Force, that the pathological mechanisms had not been worked out, that many of the research findings regarding, for example, neuroendocrine, muscular or immune system dysfunction, may be effects of the disease rather than related to its cause, and that much more research therefore needed to be done in these areas. One area where the Royal Colleges' report differed from that of the Task Force was over the question of the scale of the disease. The working group's estimate was based on just two pieces of research evidence. One was a case-control study, which is not the way to measure prevalence.
Much more work needs to be done to determine the public health burden of the disease.
Child patients, for example, have suffered terribly in the past, because of the impact the illness inevitably has on school attendance, a lack of understanding among teachers and educational psychologists, and a propensity among social workers to attribute the problems to family dysfunction. Lives have thus been blighted by the exercise of social control, when what was needed was humility on the part of professionals, and more empathy and loving care.