BPS attempts at psychologizing Long Covid

Somewhere in there is a point and I'm not sure it's lost in translation, I think the confusion is in its original Swedish.


https://lakartidningen.se/opinion/debatt/2020/10/apropa-stressreflexer-och-covid-19-symtom/

With some surprise, I note more and more reports of persistent symptoms after covid-19, and that the cause would be unknown [1]. Since I have devoted a lot of studies to stress reflexes and what they can cause, symptom descriptions from individuals with persistent covid-19 symptoms again feel too good. Stress is triggered in these cases (as in the case of whiplash injury, the Gulf War syndrome [2] and other symptom diagnoses) by the individual being exposed to a death threat but surviving.
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I am fully unable to grasp the thought process that leads to people arguing that whiplash, WHIPLASH, is psychological. It's such an odd delusion.
The brain's three stress reflexes (escape-attack, freezing reaction and play-death reaction) are characterized by about 40 different symptoms [5]: palpitations, gnashing of teeth, muscle tension, IBS symptoms, shortness of breath, fatigue that does not respond to rest, chronic pain, memory and concentration disorders, subfebrility and more. Many stress symptoms tend to become chronic as the individual finds it increasingly difficult to dismiss the symptoms as temporary.
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Sleep disturbance is often an early symptom of the stress response. The freezing reaction causes increased muscle tone, which contributes to symptoms associated with fibromyalgia [6], ie the muscles become tired even before the individual wants to use them, while the play-dead reaction causes disorders described in, among others, apathetic children [7].
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Honestly I am all up for psychosomatic ideologues saying out loud what they mean because nothing invalidates the ideology better than having people hear what they are actually saying and finding it hard to reconcile this nonsense with medical practice is supposed to be.
 
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"Pathology" seems to be a word with varied uses. Is it clear to anyone, possibly including himself, what Sharpe means? Is it the truism that when the cause of a symptom is unidentified, the symptom has no identified cause?
 
One in five COVID-19 patients develop mental illness within 90 days - study

https://www.reuters.com/article/health-coronavirus-mental-illness-int-idUSKBN27P35N

Many COVID-19 survivors are likely to be at greater risk of developing mental illness, psychiatrists said on Monday, after a large study found 20% of those infected with the coronavirus are diagnosed with a psychiatric disorder within 90 days.
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Not exactly stellar or... reliable... methodology:
The study, published in The Lancet Psychiatry journal, analysed electronic health records of 69 million people in the United States, including more than 62,000 cases of COVID-19. The findings are likely to be the same for those afflicted by COVID-19 worldwide, the researchers said

In the three months following testing positive for COVID-19, 1 in 5 survivors were recorded as having a first time diagnosis of anxiety, depression or insomnia. This was about twice as likely as for other groups of patients in the same period, the researchers said.
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Especially problematic given that dysautonomia and neurological symptoms are almost systematically labeled as anxiety and/or depression at first. And that diagnoses of anxiety or depression are never confirmed, only presumed, since we have no reliable way to confirm. Generally merely a physician's lazy opinion. It's not as if there were overwhelming reports of Long Covid patients being dismissed with anxiety or something. No, a bunch of people look at this as evidence that there is a lot of anxiety. These people are not very good at... thinking.
“This is likely due to a combination of the psychological stressors associated with this particular pandemic and the physical effects of the illness,” said Michael Bloomfield, a consultant psychiatrist at University College London.

Simon Wessely, regius professor of psychiatry at King’s College London, said the finding that those with mental health disorders are also at higher risk of getting COVID-19 echoed similar findings in previous infectious disease outbreaks.

“COVID-19 affects the central nervous system, and so might directly increase subsequent disorders. But this research confirms that is not the whole story, and that this risk is increased by previous ill health,” he said.
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Amazing how these people can endlessly point at their own failure as evidence for their ideology. It happened in the past. ME, of course. But the "it" Wessely means is a different it. Turns out accuracy is actually kind of important in science. Who knew!?
 
@rvallee
The study, published in The Lancet Psychiatry journal, analysed electronic health records of 69 million people in the United States, including more than 62,000 cases of COVID-19.
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This just tells me that people in the US who have had Covid-19 are going to be denied healthcare because, of course, being mentally ill is a choice, and they could get better if they wanted to. [sarcasm]

For insurance companies and healthcare companies in the US it must have felt like Christmas every day since the first long haulers came out of the closet - all those people who can be written off even if they've been paying premiums for years.
 
The study also found that people with a pre-existing mental illness were 65% more likely to be diagnosed with COVID-19 than those without.
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My first comment would be I dont think its safe to assume this is not influenced by observational bias because people who have had help with such problems may be more likely to seek a diagnosis for something like COVID-19. This does not necessarily mean they contract it at a higher rate. That is what needs to be investigated.

“This is likely due to a combination of the psychological stressors associated with this particular pandemic and the physical effects of the illness,” said Michael Bloomfield, a consultant psychiatrist at University College London.
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My second comment would be that this is not an helpful analysis and it is not safe to assume what is "likely". The question surely is what / how much is due to psychological stress and how much is due to direct affects on the nervous system of the virus and immune response. i.e. there are hypothesese which need testing before making handwavy off the cuff remarks as if you know what you are talking about.

In classical conditioning studies on stress, illness is known to raise the sensitivity of subjects to stressors while according to Dr Paul Cheney neurological damage causes upregulation of neurological sensitivity which may account for hypersensitivity to stimuli in ME. So my first question would be whether this phenomenon of hypersensitivity observed in ME also applies in longcovid and my second would be whether classical conditioning sensitivity due to illness is the same phenomenon seen from a different perspective or a different phenomenon. This is a complex situation which deserves to be studied very carefully.

This is why I think there is some fuzzy handwavey unscientific thinking being incautiously expressed by these psychologists, which is par for the course frankly no matter the prestige of their alma mater. I dont think the ME community will ever forget that McEvedy (the guy who invented hysteria without any research, to explain away school epidemics, to get an easy PhD) was also a psychologist at Oxford, which does not create a happy precedent and the principle of "nullius in verba" (not taking their word for it) most definitely applies.

This avenue of study needs to be held to higher standards of logic and proof.
 
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Arnie Pye said:
Did he have any evidence for that remark, or was he just flapping his lips?

Edit: What am I talking about? Covid has been around for no more than a year, so how could there be any evidence of early-onset dementia?
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Right. They were discussing mental health/psychiatric issues related to COVID and he mentioned early onset dementia with nothing to back it up.

Since he's a neurosurgeon perhaps he looked at some brain scans to reach that conclusion?
 
Mij said:
Right. They were discussing mental health/psychiatric issues related to COVID and he mentioned early onset dementia with nothing to back it up.

Since he's a neurosurgeon perhaps he looked at some brain scans to reach that conclusion?
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Yes, true. But a doctor coming out with such a horrible forecast that could affect hundreds of thousands or millions of people should have said that was what he was basing his comment on.
 
I suspect that health services and doctors all over the world, in describing 'long covid' as a 'novel' thing, may be suffering from a collective and wilful dementia themselves.

It's not exactly medicines first encounter with a very, very, similar set of symptoms after a virus - but somehow, each time it happens, it's 'novel' or 'anxiety' or any of a hundred and four other terms which means 'go away'.

Hopefully this time they might not get away with it.

(All numbers are completely made up to illustrate a point in the absence of sufficient fingers)
 
The study was of those who had been diagnosed in the last year, so may well not good control/management of their symptoms:

Importantly, the study, which appeared in the journal World Psychiatry, was designed to reveal correlations, but is not able to judge causality. Nevertheless, Dr. Volkow commented that “the proper control and management of mental disorders is one factor that will [tend to prevent] COVID-19 infection. If you’re delusional or hallucinating, you’re less likely to follow public health interventions. If you’re depressed, you may be unmotivated or you may not care.”

ETA:they then list numerous other reasons, such as housing, poverty etc that will increase their risk of Covid.
 
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