Director of Danish Health Authority Letter to the Editor JoPR

Director of Danish Health Authority Søren Brostrøm Letter to the Editor Journal of Psychosomatic Research

Topic is regarding the Danish approach to 'functional disorders' in Denmark which includes ME/CFS.

Available @

https://www.sciencedirect.com/science/article/pii/S0022399918309498?via=ihub

This is a sad development where the Danish Health Authority has bought into a faux scientific approach to ME/CFS, where the disease is apparently caused by some sort of bodily signal overload known as 'bodily distress syndrome'.

Yikes... The director honestly thinks 'chronic fatigue' is better suited for patients than 'ME/CFS' because it is supposedly more descriptive. Can't wait for him to campaign against the influenza diagnosis, once he learns the etymology of the term.

On a more serious note. This also shows the complete lack of understanding of ME/CFS, and shows that the Danish Health Authority sees the illness as simply being a condition where fatigue is present. Any ME/CFS researcher would shake their head at a understanding of ME/CFS that seems to completely ignore the immune system.

Still recommending CBT and GET of course. No surprise here.

I feel the ''succumb to pressure'' bit is particularly revealing. The Danish Health Authority sees the criticism of 'Functional disorders' entirely as misguided patient advocacy driven by patients who suffer from scientific illiteracy. They don't seem to even acknowledge that genuine criticism of functional disorders or CBT and GET is frequent in academia. This is troubling because advocates for 'functional disorders' are outnumbered significantly, yet they still somehow see it as giving into pressure from what they consider to be patients clueless about their own illness.

 

Oh dear, he thinks he's championing good science and helping patients.

 

This entire thing is so bizarre.... and so terribly embarrassing.

I mean, what does he even hope to achieve with this letter to the editor? Has the criticism really become so bad that he seeks validation from the ''international'' community of British, Dutch and Norwegian psychologists and psychiatrists? He must have an extraordinary amount of faith that 'functional disorders' and CBT / GET is the way forward. Because he had little if anything to lose before he started doubling down on the entire thing like he has been doing the past year.

Would love it if someone with a scientific background could correct his pseudoscience. Because this is just

 

Title : Risk of Urinary Tract Carcinoma among Subjects with Bladder Pain Syndrome/Interstitial Cystitis: A Nationwide Population-Based Study

Link : https://www.hindawi.com/journals/bmri/2018/7495081/

[I separated the abstract into sections to make it easier to read.]

If interstitial cystitis (IC) is a somatizing diagnosis, does this imply that bladder cancer is also a somatizing diagnosis too? <sarcasm>

There have been various papers produced about IC in the last year or two. It turns out that traditional urine analysis misses various infections that can be treated, and these missed infections can be found by investigating the DNA found in urine.

Title : Next Generation Urine Testing Now Available – Reveals Hidden and/or Chronic Bacterial & Fungal Infections

Link : https://www.ic-network.com/next-gen...n-and-or-chronic-bacterial-fungal-infections/

 

Yes, bizarre and self contradictory in its argumentation..

A number of diseases that were previously subject to stigmatization has in the modern era been destigmatized. This is the case for a number of sexually transmitted diseases, stress, depression, epilepsy, congenital metabolic diseases or malformations etc. This destigmatization has been achieved through a better understanding of disease mechanisms, development of effective and targeted treatments, information, dialogue with patients and by challenging taboos, silence and doubt. Equally, modern health care can break the stigmatization and misconceptions surrounding patients with functional disorders by meeting them with resepct and empathy, listening to their stories, understanding their symptoms and their suffering and by offering patient-centered and evidence-based treatment and care.

 

How about listening to patients when they say that the concept of "functional disorders" is nonsense, and that it's the cause of stigma, not the solution to it?

Indeed, the demonstration of this fact is right here. Do words like "succumb to pressure" increase stigmatization or not? They imply that patients are unreasonable and cannot govern themselves.

I note that one man's "succumb to pressure" is another man's "listening to concerns and making changes".

This guy has it all backwards and is a complete disaster.

 

I think this guy is suffering from functionally- low IQ disorder. And FLID is not a complex symptom.

Sadly, only a diagnostic marker(s) for ME will make the shrinks abandon their pseudo-science, their one trick pony, their it's-all-in-your-mind obsession. There should be a pathology named this inability to see reality with any compassion. What is wrong with these people?

I am struck by the power differential: patients are at the mercy of doctors' authority.

 

https://www.youtube.com/watch?v=y3vPlEm1nig

Sorry if this is a bit flippant, but when I come across doctors like this who are so certain of their psychological explanations, I'm often reminded of this scene from the 1956 version of "Invasion of the Body Snatchers."

In the video above, small town physician, Dr. Miles Bennell (Kevin McCarthy), tries to convince an old friend that her doubts about the identity of her "Uncle Ira" are all in her mind.

Dr. Bennell will come to learn just how wrong he is...


One of the clever bits in the story is that the eventual spokesman for the alien seed pods that are absorbing, duplicating and pacifying the town's population just happens to be Dr. Dan Kauffman... the local psychiatrist.

 

This letter is just ignorant political propaganda of a sort that has no place in an academic journal. But that's OK because this is not an academic journal.

The Multidisciplinary Team Is under threat it seems - and so it should be. It is a pity that some of the ME charities seem to think it is a valid concept.

 

After reflecting a bit, it's more correct to say that there exist poor attitudes towards patients with symptoms that are difficult to explain.

The functional disorder diagnosis and treatments like CBT that want to correct faulty perceptions come from the heart of these poor attitudes. The functional disorder diagnosis is not counter to poor attitudes, it's just a more formal expression of the same ideas.

Saying a few superficially kind things does not change the fact that patients are being treated like third class citizens in the healthcare system. They are not given treatment, but brainwashing sessions to stop them from seeking help for their symptoms.

 

"Complex symptoms", vs. "Common Symptoms".


What is a complex symptom? Combining many common symptoms gives us ME.Complex disease, that's ME. Seems like the Director wants to boil down ME to just fatigue, no matter what biomedical experts and pwME say.

 

Hot damn. That's just... I mean it's borderline evil. I know they probably believe in this nonsense but the incompetence is just breathtaking when it is so confidently applied. To be arguing that what they are doing has been shown wrong time and time again and argue that the solution is literally more of the same thing that has failed hundreds of millions in the past.

Take away their keys. This is madness. None of those people should be in a position of authority over anyone, they are utterly incapable of exercising good judgment. This is the bully calling for civility and compromise while they are holding us in a headlock and we're begging for air. What they're asking us is to stop resisting and just let them squeeze, for our own good of course.

 

They mean psychosomatic. They always mean psychosomatic when using similar terms. This is an ideological school of thought rooted in deceit, they claim to agree that the symptoms are real because they know they can't say the quiet part loud. So it's "complex", or "vague" or "perception of symptoms matters more than actual symptoms".

This is the fundamental failure: it is all rooted in deceit. Even their own manuals recommend to lie to the patient in order to gain their trust and better gaslight them. That they believe they are correct in doing this is irrelevant, this is extremely unethical, with a foot firmly planted in the immoral door.

 

Thank you @rvallee for your excellent explanation.

Yes, always psychosomatic. "Complex symptom" makes it sound as if it's impossible to fathom what's going on. I see symptoms as simple, even if the biomedical cause behind them is not.

On the lighter side, I pictured "complex symptoms" as something like fire shooting out of eyes, while smoke pours out of the ears, with head spinning, and limbs swinging wildly, on someone whose skin has turned green.

 

Actually, what are real and perceived symptoms? Is there a difference? And how can outstanders (i.e. someone without those symptoms) differentiate perceived vs. real? Obviously the body didn't consider developing proof systems for the outside...that egotist only wanted to ensure its own survival...

 

Basically you are a real twit if you think ME is like common mild complaints a bit amplified. To start from that basis is immediately trivialising.

 

Interstitial cystitis is described as a somatizing disorder because they cannot grow any bacteria from samples. Just recently it has been shown that urine is not a sterile fluid as had been thought. Quite simply, not all the bacteria that colonise the bladder will grow on agar plates.

The assumptions made in science and medicine can be astounding; over 60 years of passion for scientific discovery I have found over and over that today's confident assertion that something cannot be is overturned by tomorrow's research. Understandable, perhaps, but the step from "we don't know to" "nothing to know" should have a bit of humility behind it. Instead careers are built by putting in speculation over knowledge.

 

I wrote a brief comment to this letter by S. Brostrøm, the Director of the Danish Health Authority. It is titled: “Patients with functional disorders want a proper diagnosis.” It has been accepted for publication and can be read it for free by using this Share Link: https://authors.elsevier.com/a/1YZ~h_Wc9x5pd

 

Bravo!