Opinion Cognitive behavioural therapy for neurologists, 2023, Stanton, Chalder and Carvalho

Discussion in 'Other psychosomatic news and research' started by Andy, Nov 7, 2023.

  1. Andy

    Andy Committee Member

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    Abstract

    In neurological practice, we take pride in accurate diagnosis and using neuroscience to develop novel disease-modifying therapies, but we sometimes neglect symptom management and the treatment of distress. Most patients with neurological disorders report that their mental health needs are not being met. Of the many forms of psychological therapy, cognitive behavioural therapy (CBT) is the most likely to be available to our patients. This article sets out to answer the following questions: (1) What is CBT? (2) What will patients experience if they have CBT? (3) Is CBT effective for people with neurological disorders? (4) Who is most suitable for CBT? (5) How and where can a neurologist refer their patients for CBT? (6) Can we as neurologists use aspects of the CBT model in our own consultations?

    Paywall, https://pn.bmj.com/content/early/2023/11/06/pn-2023-003857


    [This was a hit for "chronic fatigue syndrome" in my daily searches, but obviously there is no sign of that in the abstract - it might be due to "Competing interests TC is the author of self-help books on chronic fatigue for which she has received royalties"]
     
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  2. Hutan

    Hutan Moderator Staff Member

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    I'm disappointed. With the title of 'Cognitive behavioural therapy for neurologists', I thought it might be the neurologists who were the recipients of therapy aiming to change their behaviour. Certainly, the neurologist I saw would have benefitted from such a therapy.
     
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  3. Hutan

    Hutan Moderator Staff Member

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    The abstract suggests that the paper is written by neurologists

    Biba Stanton 1
    1. Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
    https://www.kcl.ac.uk/people/biba-stanton
    That description of Stanton's background indicates that she is hard core FND, but also does seem to be a neurologist
    Looks like Stanton is a large part of the FND problem in the UK. I feel very uneasy seeing that she is Chair of the NICE Appeal Panel.

    Trudie Chalder 2 - last time I looked, Chalder was not a neurologist

    Carolina Carvalho 2,3
    2. Department of Psychological Medicine, King's College London, London, UK
    3. School of Psychology, University of Surrey, Guildford, UK
    I may be wrong, but the only person I can find with that name and those links is here on Linked In
    That Linked In profile suggests that Carvalho is an undergraduate student at the University of Surrey, part of the way through a Bachelor of Science - Psychology (2020-2024). She is also an 'Honorary Research Assistant' at Kings College London. This is noted as an 'indirect contract'. This began in Sep 2022. It is hard to believe that the place traditionally occupied by a senior author in the author list of a paper is taken by someone who has not yet completed an undergraduate qualification, but I cannot find a more senior person with that name listed as an employee of either of the two institutions.
    Fatigue outcomes following COVID-19: a systematic review and meta-analysis April 2023, has Chalder as senior author. It found that frequently reported associations with post-Covid-19 fatigue were female gender, age, physical functioning, breathlessness and psychological distress. And it concluded that 'Non-modifiable factors and psychological morbidity may contribute to ongoing fatigue and impede recovery.'

    In the Acknowledgements of that paper, there is this:
    "The authors thank Carolina Carvalho for her contribution to the quality assessment analysis."
    So that does suggest that Carolina Carvalho is an undergraduate student who has been working as a research assistant in Kings College London. So, not a neurologist.
     
    Last edited: Nov 7, 2023
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  4. cassava7

    cassava7 Senior Member (Voting Rights)

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    Dr Stanton was among the co-authors / signatories of Prof Peter White’s position paper against the NICE ME/CFS guideline published in the JNNP (https://jnnp.bmj.com/content/early/2023/07/09/jnnp-2022-330463).
     
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  5. Gradzy

    Gradzy Established Member (Voting Rights)

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    hmmmm
     
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  6. Sean

    Sean Moderator Staff Member

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    Pride cometh before the fall.

    Pity they are taking patients down with them.

    Besides, seems to me they are more concerned with being precise (consistent) than accurate (correct), though obviously in an ideal world they would be both.
     
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  7. ToneAl

    ToneAl Senior Member (Voting Rights)

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    They are showing their true colours they have a find mindset being biased towards the diagnosis. They will always diagnose fnd even if the evidence says otherwise. Recalling several papers come to mind prion disease diagnosed as fnd, ms diagnosed as fnd when MRI is clear, two papers come to mind 7t MRI showing damage done, when normal MRI is clear in another clear MRI is sign of progressive ms. PSP diagnosed as fnd, could go on forever.
     
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  8. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Many of our patients with neurological disorders struggle with fatigue, pain and distress, which can be the main drivers of quality of life and social functioning. The prevalence of mental disorders in all neurological patients is 55.1%.

    The 55.1% references Per Fink et al.: Mental illness in new neurological patients (2003, JNNP) —

    No reference provided for either of those two statements.
     
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  9. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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  10. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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  11. Ash

    Ash Senior Member (Voting Rights)

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    Absolute appropriation.
     
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