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Cambridge Handbook of Psychology, Health and Medicine (2007) with chapter on CFS from Chalder and Cairns

Discussion in 'Psychosomatic news - ME/CFS and Long Covid' started by Esther12, Jan 9, 2019.

  1. Esther12

    Esther12 Senior Member (Voting Rights)

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    I found that this whole book was on-line while I was searching for something else, and thought I'd post it in case others wanted to be annoyed by some poorly justified assertions that will have made life more difficult for a lot of patients.

    https://cdchester.co.uk/wp-content/uploads/2018/05/SUSANA1.pdf

    The CFS chapter is only short, and I find these sorts of short summaries are good for helping patients understand the way we're treated by GPs, etc.

    I was skimming the whole book, and kept finding annoying stuff in different sections too. I'd like to think that a book like this would not get published today, but actually I get the impression that there are swathes of academia which live in a protective bubble, immune from the growing scepticism outsiders view them with.


     
  2. Trish

    Trish Moderator Staff Member

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    Every single word of that chapter is a pile of crap. They are not even talking about CFS or ME as we know it. They are talking about fatigued patients most of whom have a comorbid mental disorder. And they specifically state a preference for the Oxford definition. I hope that book is not still being used.

    It does make me think that the patients Wessely saw in his early days of inventing his BPS theory were patients with fatiguing mental health problems, not patients with ME. Especially as he was based at a psychiatric clinic.
     
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  3. NelliePledge

    NelliePledge Moderator Staff Member

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    Chalder innit :wtf:
     
  4. JemPD

    JemPD Senior Member (Voting Rights)

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    Oh my. The most egregious bit is about the 'caregivers'....
    100 years from now, the framing of compassionate supportive care as 'reinforcing
    so-called 'maladaptive' beliefs and encouraging disability', will be seen for the pure evil that it really is.
    My beliefs are not maladaptive Mrs... YOURS ARE!
    Sometimes it becomes extremely difficult not to play into their hands by losing one's rag. Teeth are grinding here.

    I skimmed a few other chapters.... Annoying is a gross understatement :banghead::banghead::banghead::banghead: *$!*@&$*!%* oh my goodness they make me want to swear. I don't give a monkeys about all those references, we already know that much of psych research is scientifically bankrupt, & this is, from what i can see, merely a load of opinions presented as facts with the appearance of loads of studies to back it up.
    In 50 yrs it will read like the 'low fat diet' nutritional advice of the last 30yrs
    (see here https://www.s4me.info/threads/the-s...-rules-of-human-social-life.7565/#post-134429)
    But God help us all in the meantime :(
     
  5. shak8

    shak8 Senior Member (Voting Rights)

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    Maddening. May those psychs and shrinks or their loved ones get one of our illnesses. Then let's talk. Until then, trust what the patient says.

    Reminds me of my new primary doc. I describe my pain (thus justifying the drugs that enhance GABA, including one low-dose opioid). To which he nods with sympathetic understanding and utters: have you tried massage?
    Yeah, bro. Massage worsens it x50, as does ole acupuncture. Twenty some years of trying stuff. I know what works and what does not. I am going to write my medical memoir and send copies to researchers. And thrust one in my primary's hands. Read, as God said to Mohamed (I think that's how it goes).

    Christ.

    I crashed today. Dizzy and body just caved. Never happened that way before. Must be psychosomatic, eh? I'm beginning to believe after all these years that I do indeed have CFS, however mild.
     
    Last edited: Jan 10, 2019
  6. Sean

    Sean Moderator Staff Member

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    The reference list alone gives the game away.
     
  7. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    Just selected one of the comments: about misdiagnosis is rare - in other words they say they don't overlook other health issues - yes they do, some 40 percent of the time re studies to this effect.

    Very concerning to think this book may be used for a long time. What twigs practitioners to consult newer, appropriate medical information, especially if governments stall in up dating health care workers? Some who don't notice the scientific advances in this field will continue following this nonsense, and possibly harming their patients.
     
  8. chrisb

    chrisb Senior Member (Voting Rights)

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    Interesting to read the contribution by Bass on Psychosomatics-in particular page 196, on the count, where chronic fatigue syndrome is referred to as a functional somatic condition. Now, we know from Jenkins that this is what was taught and that the functional illness was hysteria. (Post viral fatigue syndrome (ME) 1991 eds Rachel Jenkins and James Mowbray. Introduction @p25.)
     
    Invisible Woman, andypants and Trish like this.
  9. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    Yes pretty much total crap. You can see the circles she mist exist in to be so out of touch with the biomedical approach to the illness and patients themselves. She claims ME and PVS are inaccurate yet immediately just reduces her CFS to CF, a wildly inaccurate framing and presentation of ME. She clearly doesn’t like fukuda which was far better than oxford criteria and at least recognised symptom clusters beyond fatigue.

    Full of assumptions, paraphrasing ,” they take daytime rest which affects sleep “, “beliefs that activity will harm are catastrophic”. Anyone who thinks ME can be adequately captured and diagnosed with oxford is just way off but there hasn’t been enough in the UK vocal consistent opposition to this underlying psychological framing of our illness or their criteria.
    She’s applying her dumb approach to all fatigue in illness though I think. CBT is the answer to every question isn’t it.
     
  10. chrisb

    chrisb Senior Member (Voting Rights)

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    F
    Fatigue is the Central Africa of medicine, an unexplored territory which few men enter.

    Putting aside all temptation to make a joke about the Lightning Process and its originator, this is the quotation with which Wessely, Hotopf and Sharpe begin the Preface of their book Chronic fatigue and its syndromes. This comes from Beard's 1869 paper, Neurasthenia, or nervous exhaustion. Fatigue is all that it is about.
     
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  11. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    That’s such a Wesselyian quote. No doubt like former colonialists he thought to claim and conquer that territory. He would say the natives too savage.

    So wessely was quoting the psychiatrist who reduced us to hysterics? What a shame fatigue wasn’t viewed as a physical symptom like pain.
     
    Last edited: Jan 10, 2019
    obeat, shak8, alktipping and 8 others like this.
  12. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    No. The problem isn't merely conflation of mental disorders with CFS. They're talking about poor quality easily-biased research and claiming it is somehow generalisable/conclusive evidence.
     
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  13. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    Unfortunately, pain is also seen as psychogenic.

    For a few months I saw a health professional who misdiagnosed me, albeit still with a significant physical problem, unrelated to ME. Even though I said I was frequently in pain from this problem, this practitioner essentially told me I wasn't, and indirectly warned me not to tell other practitioners I was in pain, because this diagnosis shouldn't cause pain (the wrong diagnosis).

    I eventually saw another practitioner higher up the chain of command, who really misdiagnosed me - said there's nothing wrong, and completely ignored my pain.

    Finally saw another equivalent higher up the chain practitioner who correctly diagnosed, and fixed the problem. I'm "lucky", this took less than 18 months to fix!
     
  14. rvallee

    rvallee Senior Member (Voting Rights)

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    I believe the proper scientific term for this is: dumpster fire.

    Something for which data do not exist, it's a baseless assertion. This is exactly the kind of thinking that lead some to claim that it does not affect children, until someone actually checked and now of course some of the same people who claimed it did not affect children have now turned their gaze to those easier marks who are less likely to complain, especially when parents are threatened with having their children taken away if they dare complain.

    I know that my keys are not in the basement because I did not look in the basement.

    That would be great if that was the case but the very same people saying that nonsense are also saying that no attempt should be made to diagnose as it itself reinforces the "illness belief". CFS is a grab bag of the undiagnosed and misdiagnosed, it's guaranteed that most will eventually have an actual diagnosis but since recommendations are to not waste time on "heartsink patients" this rarely happens.

    This is embarrassing garbage. It's also nearly identical to past embarrassing garbage that argued the exact same thing about other diseases pre-breakthrough.
     
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  15. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    I do accept pain can be ascribed to psychogenic cause , unfortunately that seems to be the medical default. But pain from recognised illness is more respected, there’s been research and multiple drug options available.

    Even in recognised Illness like MS and cancer it seems fatigue has been hugely under researched despite patient complaints on it, and is still often part psychologised or left to psychologists to manage whilst the scientists focus on the trying to underlying disease. That might seem fair enough as ‘disease cure ends fatigue” but I think fatigue has been “unsexy” across the board and could have been investigated and respected more which would have benefitted us or we could have been investigated more which would have benefited them.
    .
     
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  16. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    I agree @Cinders66, pain in recognized diseases is respected. So is fatigue, in say a cancer diagnosis.

    Constant, or frequent pain can be fatiguing. I am not making light of this, not at all, when I say, because both these symtpoms are hard to understand, and are stigmatized, means more hurdles to overcome to get accurate medical treatment.

    And I agree, fatigue is not seen as sexy. Many make light of it, which is one of the problems for us with the stupid, crap label "chronic fatigue syndrome".
     
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  17. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    "Dumpster fire, garbage can, waste basket diagnosis indeed!"

    Misdiagnosis on a grand scale? on the ME Research UK website:

    http://www.meresearch.org.uk/information/publications/misdiagnosis-on-a-grand-scale/

    Two studies cited: 1) 2010 - 40% of referrals to the Newscastle CFS/ME Clinical Service "were eventually diagnosed with other conditions" - primary sleep disorder, PTSD, cardiovascular disorders, and psychological/psychiatric illnesses.

    2) 2012 - GP's referrals to specialist clinic at St Bartholomew's Hospital, London - only 54% confirmed as "CFS" patients. Corrected diagnoses included:" sleep disorder, endocrine disorders, nutritional disorders and pain disorders, and psychiatric disorders."

    Other alternate/corrected diagnoses noted in this article, but outside these two studies include:" Addison's disease, MS, sleep apnoea, primary mitochondrial disease, primary liver disease, and paranoid schizophrenia."

    "These reports provide clear, formal evidence that almost half of patients referred from primary care with a diagnosis of ME/CFS actually have something else wrong with them – a fact that is not discovered until they are lucky enough to be seen at a specialist clinic. This seems like misdiagnosis on a grand scale."

    Apparently, some health professionals view pwME as so mentally ill, they can't differentiate paranoid schizophrenia from ME!
     
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  18. Dolphin

    Dolphin Senior Member (Voting Rights)

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  19. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

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    As posted in the other thread:

    Coding of "Neurasthenia" in classification and terminology systems:

    ICD-10:


    In ICD-10 (endorsed by the Forty-third World Health Assembly in 1990), postviral fatigue syndrome (G93.3) is specified as an Exclusion under F48.0 Neurasthenia in ICD-10 Volume 1: The Tabular List:

    https://icd.who.int/browse10/2016/en#/F48.0

    Chronic fatigue syndrome
    is indexed to the G93.3 Tabular List code.


    Extract: NHS Digital, National Clinical Standards ICD-10 5th Edition, Page 84:

    https://hscic.kahootz.com/gf2.ti/f/...oding_Standards_ICD10_reference_book_2019.pdf

    [​IMG]


    ICD-11:


    For ICD-11, the legacy entity Neurasthenia has been subsumed and replaced along with most of the ICD-10 Somatoform disorders with the new single category, 6C20 Bodily distress disorder (with three coded-for severity specifiers).


    SNOMED CT:

    SNOMED CT is a standardized electronic terminology system for recording and sharing symptoms, diagnoses, clinical findings, procedures etc in primary and secondary care and across other health care settings.

    Since April 2018, SNOMED CT UK Edition has been the mandatory terminology system for use in NHS primary care, replacing the Read Code (CTV3) terminology which is now retired. SNOMED CT UK Edition is scheduled for adoption across all NHS clinical settings by 2020.


    For the SNOMED CT terminology system, the SCTID Concept term Neurasthenia and its associated terms were retired ("Inactive") from the terminology system a number of years ago.

    Although the various SNOMED CT national editions absorbed the retirement of this Concept term in their next releases, the Netherlands Edition had retained the term "neurasthenie" under the chronischevermoeidheidssyndroom (CVS) Synonyms list, coded to the SCTID: 52702003 CVS Concept code and marked as exclusive to the Netherlands national edition.

    In October 2018, @mecvsnieuws on Twitter approached Pim Volkert (Coördinator terminologie bij Nictiz) with a request for retirement of the term neurasthenie from the Synonyms list for Concept SCTID: 52702003 chronischevermoeidheidssyndroom for consistency with the International Edition, with other national extensions, and with the WHO's ICD-10.

    As reported in this thread, this request and accompanying rationale was accepted and approved for implementation in the March 31, 2019 release.

    For the March 2019 release of the SNOMED CT Netherlands Edition, the term neurasthenie has been deleted from under the chronischevermoeidheidssyndroom (CVS) Synonyms list and marked as "Inactive".
     
    Last edited: Apr 9, 2019

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