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Yep. The negative physiological response to activity, particularly the delayed component (PEM), is the core of the disease. Until it is also at the core of research and clinical practice, the decades-long failure to come up with a realistic explanation and effective treatment will continue.

How to disappear an inconvenient disease. (I actually doubt that decline is true.)

All these conditions are believed to be associated with centrally driven mechanisms such as central sensitisation. Believed by some. All studies scored moderate to high quality on the Newcastle-Ottawa scale. There was a general trend for decreased low-frequency EEG band activity (delta, theta...

Worth repeating with emphasis.

+1

Oh, the irony.

We can do better than that. More than 80% is "very low quality", with the remainder being merely "low quality". (Can't remember the exact numbers.) Hard to get much worse than that.

Grift.

Always awkward when one of your leading proselytisers falls for the hokum that is intended for the unwary masses.

Further exclusion criteria included... non-acceptance of their CSS diagnosis or unwilling to take part in a group-based therapeutic intervention. They are not even pretending anymore, are they. How much more blatant does this corruption of methodology and ethics have to get before the rest of...

There are two forms of generic empty gel capsules you can buy. The clear one for non-enteric medications, and the opaque white ones for enteric (coated) medications. For blinding the white ones have the advantage of hiding the contents, so you can't tell what is in them. I don't know if...

In fairness, in many situations it is going to be practically difficult to do much accommodation to these needs. For example, in most health systems there is just isn't the funds available to do home visits, and having worked in the hospital system many lifetimes ago it is hard to see how...

Wiborg, et al. 2010. They are indeed arguing backwards. Their claim is that because subjective self-report fatigue was not correlated to objective actigraph measurements, therefore it must be the objective measure that is wrong or irrelevant, not the subjective measure. But if anything that...

There are some jobs for which a diagnosis of ME or LC should make that person ineligible for the job. Hate saying that, but these conditions (and no doubt others) potentially compromise competence too much, particularly in situations where critical decisions have to made on the spot, without...

I remain agnostic about it being one thing, variations on one thing, or a bunch of different things. None of those possibilities would surprise me. Still insufficient data to draw reliable conclusions.

It would not surprise me if there turned out to be some sub-types of ME. There are for many diseases. It might even be the normal situation. But each disease group still has something in common. Cancers, for example, are a failure to restrain cell growth. None of which excuses simplistic...

Doubt LDN will prove particularly useful, but we need a robust trial or two to establish its potential either way.

If the study can provide definitive answers either way then it is probably worth doing.

Nothing could possibly stigmatise mental health more than inappropriate mental health diagnoses. And here we are.

Indeed. I have long been of the view that when we get a good handle on the problem, it is quite likely to turn out to be common and undiagnosed/misdiagnosed, particularly in its more mild forms where PEM may not be such a distinct feature.