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There's criticism of the biopsychosocial model too: They raise the issue of stigma The problem is dualism, because... people are complex The biopsychosocial model is criticised as creating work for patients to prove that their symptoms are real and that they are worthy of help.

An output of the PACFIND project looking at service provision for fibromyalgia. I'm interested in this in the light of the Royal College of Physicians work on service provision for Medically Unexplained Symptoms. I think that means they did a literature review, creatively. it covers...

Fibromyalgia is a syndrome characterised by persistent unexplained pain and fatigue. People with fibromyalgia report receiving little support to manage symptoms, difficult interactions with healthcare practitioners and stigma associated with this contested condition. In this article, we employ...

Given what we have heard from the Royal College of Physicians lately, this seems to foreshadow a renewed effort of funding clinics run by psychologists and physios to scoop up all the Medically Unexplained Symptoms people, to stop them taking up the time of doctors for proper diseases.

Thanks Dx Revision Watch, interesting

I thought it might be useful to know some more about Dr Theresa Barnes - the author of the Editorial Royal College of Physicians - Clinical Lead for Outpatients A rheumatologist - I wonder @Jonathan Edwards if you know her? And the RCP lead on Outpatients Services Countess of Chester Hospital...

No, I think as you have concluded, it isn't a big task to comment that BPS treatments and clinics have no evidence to support them. It can be done in a few sentences but I think it probably deserves more here. We could labour to produce the perfect sentences, but the opportunity has passed...

The problem is, Katharine's article is not fundamentally misaligned with those other articles. The aim of the paper seems to have been to convince readers that people with 'enduring symptoms' can be very ill indeed, very disabled and living very restricted lives, that there is an absence of...

I think you have missed the context Rvallee. If Katharine's article was just an article on its own, it would be okayish, although the framing of ME/CFS as 'enduring symptoms' is a bit problematic. If you read through the thread, you will see that I started thinking that the article was good...

The study had no controls. it is likely that some people improved naturally over the four weeks. When there is no control treatment and blinding, subjective outcomes such as 'rate your fatigue on a scale from 1 to 10', become very unreliable. If you think you are taking something that will...

Presumably the 'chronic, often debilitating symptoms and syndromes for which medical evidence of disease cannot yet be found' encompasses ME/CFS? The clinical literature abounds with references to ME/CFS. Yes, in BPS circles, ME/CFS can be described in the clinical literature as 'medically...

Here's another of the articles: Challenging Myths: Debunking Functional Disorders Breaking barriers in the education of persistent physical symptoms It's deeply ironic that the special edition title is 'challenging myths'. The first paragraph of the abstract runs as follows: The article goes...

But you told us upthread that you were required to add a paragraph to the article about the terminology, which promotes the terms medically unexplained and functional symptoms as 'widely used in clinical literature'. And, even your abstract, which you say no one influenced, uses the term...

Yes, those articles by Burton and Ellis are truly awful, full of misrepresentation of studies that did not in fact find what is claimed. Trish and Katharine, Katharine's mostly fine article has been commissioned and used to 1. provide a veneer of 'we are listening to the patients', and 2. help...

In the same way that Cochrane used the IAG committee for years to suggest that patients were being listened to, I think the RCP has used patient representatives to suggest care and concern for people with, well, whatever they are calling these disorders today. And to help make the case for...

I could see that too, Trish. But Katharine tells us that the RCP discussions weren't about planning a series of articles or even about patients, but rather about clinical practice. Yes, I hope so too. But I suspect the message the readers of the special edition will take away, primed by the...

This is looking very concerning indeed when combined with the recent MEA and Elaros work. I think there's a need for more openness about what is being planned. That editorial suggests that the RCP is deeply committed to a plan for care that I would term, if not disastrous, then at least no...

Here's the link to the editorial for the special issue on 'Challenging myths: debunking functional disorders' by Theresa Barnes. There's not much debunking going on in the editorial. It's all very much BPS business as usual, with the biological given a bit of acknowledgement, but only as part...

Thanks for that context @kacheston. It sounds as though the process of creating the article has been valuable advocacy work in itself. The journal is affiliated with the Royal College of Physicians; I do wonder what the clinicians you came across made of your information. I see the special...

Mmm, dulce de leche, too nice a thing to be associated with MUS.