Blog: Spoonseeker: Probing the Holes in MUS

[Art Vandelay]

Friends with MS talk about knowing something was seriously wrong even before they were diagnosed little realising how lucky they were that their disease had got past the psychogenic description it once had.

A colleague's sister fell very ill and for over a year she endured a similar experience to that of many of us who have ME/CFS. A range of sceptical doctors and specialists labelled her as "anxious", "attention seeking", "depressed" and told her that her baffling symptoms were "all in her head".

Eventually it turned out that she had an extremely severe case of MS that was progressing rapidly. She missed out on a year of treatment due to the lack of a diagnosis and her prognosis was grim.

These MUS quacks and charlatans (and indeed, the bulk of the medical profession who go along with this nonsense) have a lot to answer for.

 

[Inara]

Yes, we do.

Rheumatological symptoms that did not have a reasonably clear explanation were less than 5% of my referrals. Symptoms that looked as if they arose from beliefs or fears were 0.5% or less.

It would be interesting and fairly easy, as someone says, to check this if old letters still exist. I could pull up 500 consecutive letters and see how many involved symptoms I could not explain. I could do it for colleagues too - which might be interesting! The hassle would be the ethical committee approval and all that stuff. It really needs an enthusiastic trainee wanting to write a paper to do the spadework. It would actually be best to get someone else to do the assessment. I might even be able to get someone interested, although I am not in touch with my department so much now and the old records may all be destroyed.

This is a great idea!

 

[Sly Saint]

 

[chrisb]

A thought has struck me. They don't often, so I thought I would share it.

Some may have noticed my observations on another thread about "Abnormal Illness Behaviour" as described by Pilowsky in 1969. It was to have been the big idea of Wessely, David and Pelosi that this would replace hysteria in discussion of ME. The idea was much trumpeted by Goldberg in 1991 (-although it is possible that Goldberg was merely a name on a paper authored by Woods), but was never again, so far as I can tell, mentioned by Wessely. This is suspicious.

It may be that Pilowsky himself threw the proverbial spanner in the works. He elaborated on the idea and made it clear that it placed a heavy onus on the doctor to be both plausible and correct. It is hard to see how this could apply in the case of diagnoses contested not only by patients but also by respectable medical opinion. This problem can be overcome if instead of having separate diagnoses for the various syndromes everything is simply lumped together and called unexplained. Abnormal Illness Behaviour included most of the diagnoses which would now be regarded as MUS, so AIB never disappeared, it merely changed its name.

If MUS goes back to the early to mid 1990s the timing would be correct.

Perhaps this was the big idea that saved the Institute of Psychiatrists, and made them believe they were relevant.