Review Aetiological Understanding of Fibromyalgia, IBS, CFS and Classificatory Analogues: A Systematic Umbrella Review, 2023, Rosmalen et al

[Dolphin]

Free fulltext: https://cpe.psychopen.eu/index.php/cpe/article/view/11179

Aetiological Understanding of Fibromyalgia, Irritable Bowel Syndrome, Chronic Fatigue Syndrome and Classificatory Analogues: A Systematic Umbrella Review
Authors

• Maria Kleinstäuber
  Department of Psychology, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT, USA
• Andreas Schröder
  The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
• Sarah Daehler
  Department of Psychology, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT, USA
• Karen Johanne Pallesen
  Danish Centre for Mindfulness, Aarhus University, Aarhus, Denmark
• Charlotte U. Rask
  The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Aarhus, Denmark
• Mathias Sanyer
  Department of Psychology, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT, USA
• Omer Van den Bergh
  Department of Health Psychology, University of Leuven, Leuven, Belgium
• Marie Weinreich Petersen
  The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
• Judith G. M. Rosmalen
  University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

Abstract

Background:

This umbrella review systematically assesses the variety and relative dominance of current aetiological views within the scientific literature for the three most investigated symptom-defined functional somatic syndromes (FSS) and their classificatory analogues within psychiatry and psychology.

Method:

An umbrella review of narrative and systematic reviews with and without meta-analyses based on a search of electronic databases (PubMed, Web of Science, Embase, PsychINFO) was conducted. Eligible reviews were published in English, focused on research of any kind of aetiological factors in adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and somatic symptom disorder (SSD)/somatoform disorder (SFD).

Results:

We included 452 reviews (132 systematic reviews including meta-analyses, 133 systematic reviews, 197 narrative reviews), of which 132 (29%) focused on two or more of the investigated health conditions simultaneously. Across diagnoses, biological factors were addressed in 90% (k = 405), psychological in 33% (k = 150), social in 12% (k = 54), and healthcare factors in 5% (k = 23) of the reviews. The methodological quality of the included systematic reviews (k = 255) was low (low/critically low: 41% [k = 104]; moderate: 49% [k = 126]; high quality: 10% [k = 25]). The high-quality systematic reviews suggest that deficient conditioned pain modulation, genetic factors, changes in the immune, endocrinological, gastrointestinal, cardiovascular, and nervous system, and psychosocial factors such as sexual abuse and pain catastrophizing increase the risk for FSS.

Conclusion:

Only very few systematic reviews have used comprehensive, biopsychosocial disease models to guide the selection of aetiological factors in FSS research. Future research should strive for higher scientific standards and broaden its perspective on these health conditions.

 

[MeSci]

What a load of absolute cr*p.

 

[rvallee]

symptom-defined functional somatic syndromes

Symptom-defined? As opposed to... what? By definition syndromes have to be symptom-defined, since this is, you know, the damn definition of what a syndrome is. This is like when people try to dismiss symptoms as being patient-reported, the very definition of what symptoms are. It's always revealing when people do that.

The conclusion makes no sense at all. How is that even a thing worth mentioning, let alone make a conclusion out of it? 90% of the reviews being of low quality is an underestimate, and somehow their conclusion is "hey, what about the very low quality stuff we've been obsessed with for decades? how about more of it?".

They're basically arguing that there is too much focus on biomedical processes, which is laughable, while making a very poor case for more of the useless psychosocial quackery that has produced nothing at all. It's just a rambly way of asking for money to keep doing the same useless stuff.

This is not what science is supposed to do. It's a perversion of the role of science, and the mission of medicine. These people are completely egocentric, focused only on themselves and unable to consider the patients as real people.

 

[Solstice]

Rosmalen hedging her bets for when she gets booted out of her position as a lead on the "biomedical" ME Lines project?

 

[shak8]

The money saved from paying silly people employed in academe (reference the above and so many other 'research' reports) would be better spent on working our carbon load down, or improving the lives of the not as fortunate.

 

[Sean]

Future research should strive for higher scientific standards

Feel free to show us how it is done...

 

[Grigor]

It once again shows how funding research done by Rosmalen is often waisted money that should've gone elsewhere...

 

[SNT Gatchaman]

There's an interesting passage in this review, relating to FND explanations —

Second, current explanatory models promote a biopsychosocial approach to diseases in general. However, since the appearance of IBS, FMS and CFS/ME as MESH terms in MEDLINE from 1989 onwards, very few systematic reviews have used comprehensive disease models to guide the selection of aetiological factors in FSS research. The still widely acknowledged dualistic "hardware versus software" rationale likely has slowed down scientific progress and might continue to do so until it is replaced by empirically based pluralism.

FYI @dave30th

 

[dave30th]

There's an interesting passage in this review, relating to FND explanations —

That's interesting, since it's the first acknowledgment by any of these people that hardward/software is a completely dualistic framework--and the FND people have spent years promoting it and are now trying to backpedal from it.

 

[Sean]

the FND people have spent years promoting it

While imputing it to the thinking of others, criticising others' models on that basis, and describing their own approach as integrative, going beyond the 'mind-body dualism'.

If the software-hardware analogy is not the epitome of dualistic thinking, I don't know what is.

 

[rvallee]

That's interesting, since it's the first acknowledgment by any of these people that hardward/software is a completely dualistic framework--and the FND people have spent years promoting it and are now trying to backpedal from it.

Still eating their cake, though. They may distance themselves from it, but they're scarfing it down like it's about to run out. And selling it. And marketing futures. And selling NFTs and "best of" albums of it.

And given that lying about what the model is is part of the model, it's probably posturing that actually means the opposite. No way are they back-pedaling, it's the same old cycle of constant recycling of the same old ideas.

The "pluralism" is probably expanding the model. The modern biopsychosocial model basically uses as explanation that it's "a complex interplay of bio- psycho- and social factors". So they're likely not abandoning dualism, they're more likely to expand the dimensions. To the original three, which is the basic model. Nothing matters, these people think that explanations are valid knowledge, even when the explanations predict nothing and make no sense of reality.

In science explanations mean nothing. Predictive models matter. The rest is stories along the way. But the biopsychosocial model rejects science, so naturally it always goes in the wrong direction.