Difference between Australian chronic fatigue syndrome guidelines and ME

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Another good article by Sasha Nimmo:

Australians are having their concerns dismissed by GPs, receiving harmful medical advice, refused insurance claims, refused access to support services, denied access to the Disability Support Pension and the National Disability Insurance scheme. In tens of thousands of cases, they are misdiagnosed or wait decades for a diagnosis. Read these excerpts from the chronic fatigue syndrome guidelines and see the problems.

This is in large part due to the 2002 Australian Guidelines for chronic fatigue syndrome. The CFS guidelines were paid for by the Australian Government, written by the Royal Australian College of General Practitioners and published by the Medical Journal of Australia. When your doctor, specialist, health department or people working in other government departments, insurance companies or superannuation organisations are deciding about your illness, they consult this government document.
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OZ Guidelines – Disability can be defeated through treatment
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full article here:
https://meaustralia.net/2018/11/30/...n-chronic-fatigue-syndrome-guidelines-and-me/
 
If you think the final 2002 version is problematic (and it is), the initial draft they put out in 1997 was a complete fucking nightmare. The final version is a vast improvement on the draft.

The fact it took 5 years to finalise gives you an idea of how much objection there was to it, and how hard the fight was.

The final version looks bad now, in 2018, with the benefit of all that has happened since. But at the time it was a (relatively) significant step forward.

This part alone was a huge win, IMO:
In the absence of evidence of malingering, speculative judgements about unconscious motivation should be avoided. The psychoanalytic concept of “secondary gain” has been misused in medicolegal settings and does not rest on a solid empirical base. In evaluating patients with CFS, hypothesised secondary gains should be weighed against manifest secondary losses. The notion of “abnormal illness behaviour” is contentious, and the term should not be used as a diagnostic label.
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(Almost certainly by complete coincidence, that quote is literally the last words in the document, besides the references section. :) )

https://www.mja.com.au/system/files/issues/cfs2_2.pdf
 
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I can’t even imagine how bad the earlier versions were.

As soon as the 2002 Australian guidelines were released they were condemned by the Senate, by the old national ME/CFS Australia and the Alison Hunter Memorial Foundation. The strength of their statements shows how vehemently they protested against them.
 
adambeyoncelowe said:
I believe the Unholy Trinity did a lecture tour Down Under. So it all comes back to us eventually.
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I am not sure it is that straightforward. It looks to me as though there was a lot of trans Atlantic cross fertilisation of ideas. The likes of Kleinmann and Eisenberg seem to have influenced Goldberg, who seems to have been at the centre of everything. Mechanic and Pilowsky thought on broadly similar terms, though how the pieces of he jigsaw fit together is unclear, as yet.

There is even a video on YouTube on which it is said that Goldberg held four posts at the Institute of Psychiatry and that he saved that institution - though it fails to elaborate on "from what" and "for what".

EDIT There was also the work of Imboden upon which great reliance seems to have been placed to justify their views.
 
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Yes, Wessley and White still very influential here.
As well as being the recipient, Australia also exported psychiatrist Ian Hickie’s work, he’s one of the authors of the Fukuda CFS criteria and the Australian CFS guidelines.
 
MyalgicE said:
psychiatrist Ian Hickie’s work, he’s one of the authors of the Fukuda CFS criteria and the Australian CFS guidelines
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The original 1997 draft Australian Guidelines had his grubby fingerprints all over it. Can't prove that, but I strongly suspect that Rob Loblay (formal lead author for the guidelines) got shafted by Hickie in the draft, and had to fight both sides to get a more reasonable final version. Loblay was clearly seriously burnt by the experience, and I have some sympathy for him.

Hickie is one of those who has managed to fly under the radar for his role in this catastrophe. He has been a hardcore psychosomatist all along, yet his name is hardly mentioned or recognised in this debate. There is no doubt he played a serious role in how this has turned out.

In fairness, he has done some good work on mental health. As I understand it, he was one of the driving forces behind Beyond Blue, a major depression and mental health initiative in Australia, which by all accounts has done considerable good, at least by raising awareness and acceptance of these issues. No doubt that Australia is much better for it.

But he got ME/CFS completely wrong. He is completely in the Wessely school (or was, haven't heard much from him lately on ME/CFS, he may have made a strategic withdrawal, at least from any public role).

Either way we ME Aussies are paying the price for his, er, input.

P.S. For those who have not actually read Fukuda in its entirety, it is well worth the effort. There is actually some good stuff in it. It was just completely ignored by the psychophiles. They tended to prefer Oxford anyway.
 
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