Framework for systematic reviews on psychological risk factors for persistent somatic symptoms & related syndromes & disorders (PSY-PSS) 2023 Hüsing

Introduction: Numerous psychological factors are believed to play a pivotal role in the development and maintenance of persistent somatic symptoms (PSS) in all fields of medicine. However, very few of these factors have been empirically investigated in relation to PSS. The aim of this study is firstly to propose a framework and define search terms for systematic reviews on the empirical evidence and diagnostic value of psychological risk factors for PSS and PSS-related outcomes (PSY-PSS). Secondly, the application of the framework is illustrated using the example of a systematic review on the relevance of psychological factors in somatic symptom disorders (SSD; DSM-5) and bodily distress disorders (BDD; ICD-11).

Methods: Following a narrative review approach, two comprehensive lists of search terms to identify studies in (1) relevant patient groups with PSS and (2) relevant psychological factors were generated by reviewing the current literature and employing an iterative process of internal revision and external expert feedback.

Results: We identified 83 relevant symptoms, syndromes and disorders for which we defined a total of 322 search terms (list 1). We further comprised 120 psychological factors into 42 subcategories and 7 main categories (list 2). The introduced lists can be combined to conduct systematic reviews on one or more specific psychological factors in combination with any symptom, syndrome or disorder of interest. A protocol of the application of this framework in a systematic review and meta-analysis on psychological etiological factors of SSD and BDD is presented following the PRISMA guidelines.

Discussion: This framework will help to gather systematic evidence on psychological factors in order to improve the understanding of the etiology of PSS, to refine future diagnostic conceptualizations of PPS, and to develop optimized mechanism-based interventions for individuals with PPS and related syndromes and disorders.

Open access, https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1142484/full

 

It's a convenient narrative to create or justify inequality in healthcare.

 

Classifies CFS & ME separately under Neurology, along with neurasthenia (after all it is the 19thC)

 

No it won't. It's literally the same as always. But that's the "framework" they operate on: no one cares, just repeat the same stuff over and over again.

As they say, this is a belief system. It even features the defining characteristic pattern of doubling down on beliefs when they are debunked.

It's literally always the exact same thing. Psychosomatic medicine really should be renamed medical theology.

Hell, they even admit they don't have evidence and don't even care:

Clown show.

And the fact that patients insist otherwise clearly doesn't bother them. Of course it's the symptoms, the illness, that is the problem. That's literally why patients go to see doctors. The textbooks do say that, and it's a Big Lie, oblivious and indifferent to reality.

 

Hell, they even admit that they are biased and only looking to confirm. This is not science! It's completely excessive bias and it's not even a secret that it's not a serious process.

It "should be" predictive, even though after decades and thousands of experiments they never managed any of this. But they've been saying so anyway so they still insist that it "should", because that's the belief system. And they've been trying to fraudulently manufacture evidence for decades, exactly this way, and still think that it's a valid way of doing things.

They're not even ashamed of the fact that they manufacture completely biased evidence. They don't think it's a problem, because it's a culturally accepted practice. This is the literal definition of pseudoscience.

 

YES. IT. IS!

I dont have health anxiety & i dont catastrophise. Well, i do about some things, but not about my health.

 

You know, this actually kind of makes sense. A decade ago, back when I was told by a psychiatrist i had a psychosomatic illness and sent to a psychologist to find the cause, i wasted a year talking to this guy and i kept asking "ok, you just talk to me about random stuff but can we find this psychological problem and fix it so i can go back to being able to do things?".

At the beginning he had the excuse of saying "we just started, we are getting there" but soon it became obvious that he had no game plan, there was no systematic technique that he was applying to try to figure out my psychological problem, he was literally just talking about random things and that's all he was able to do, like a con artist pretending to be skilled at psychology except that's actually just how psychology works. They just talk to you about irrelevant things and the Phantom psychological problem is supposed to pop up out of nowhere (except it never does).

Every time I have mentioned this to a doctor, the blame was shifted on me: psychological causes are insidious to find and i was too stubborn to be helped. Regardless of what your view may be on this, it seems a bit strange that the process psychologists use is never called into question, no? Surely there is room for improvement, if the problem is so insidious to find, but nobody ever talks about it. Psychologists are mythical beings that are perfect at their job apparently so there's just no need to talk about it. In every other field we talk about what we are doing and how to improve, but not in psychology. Seems a bit suspect if you ask me.

This paper says that those psychological factors should be systematically classified and be predictive of symptoms and illness. There should be clear evidence on how they work, in great detail. I think the authors of this paper have missed the memo that the reason these things are kept vague is that they are bullshit you can only shove down people's throats by keeping a secretive veil over the whole thing. They are specifically designed to be opaque so doctors can make vague claims in order to keep difficult patients between a rock and a hard place.

 

Amazing. These authors inhabit another world. Table 1 is quite something...

Syndrome X. Seriously? In the land of actual medicine, we call this "microvascular angina". Cardiologists diagnose INOCA ("Ischaemia with Non-Obstructed Coronary Arteries). There's a global consensus document on it (see this thread). I do agree that consensus document should have been written by 1980 at the latest.

Chronic intractable benign pain syndrome. Benign pain? Righto. Thankfully not a term used since the 70s or 80s.

I had a look at culture-bound syndromes also. Perusing Wikipedia examples, more than one sound like the local term for dysautonomia / POTS / ME.

Eg, the apparently uniquely Russian / ex-Soviet republics' "Vegetative Vascular Dystonia" —

Then there's the (new-to-me) and surprisingly named Brain Fag Syndrome —

I look forward to this ethical scientific rigour of which you write.

And convince me that Ghost Sickness is not largely ME/CFS.

 

Yes interesting to have the full list.

Or alternatively we can take one from the psychiatry list and define the 'they think this exists, rather than admit it is their own bigotry' syndrome suffered by all those who believe this:

and just call this billions and billions of pounds/dollars etc industry 'culture-bound syndrome' - it is just it exists in the mind of the doctors and other believers and not the patients.


And see this whole list as the bunch of cover-up terms used for whatever self-interest or delusion is behind the person using them.

I think it is a syndrome that exists in the mind and culture of medics and other individuals and I'm pretty sure that I am correct and science absolutely backs that up. They just need little TV programmes pretending looking at half the women coming in in such a way is 'normal' to make themselves feel better.

The fact they have to write silly little made-up stories and revert to sea-lioning, distraction and fallacies when they talk about it then normal talk-down the victim they are targeting with such labels says it all and makes me wonder why these people don't have wake-up call moments when they hear themselves doing these things one day.

 

Yes, psychosomatic was only 'under' the field of scientific psychology on the basis of it being one area that needed to be 'audited' and kept to standards, not because it is actually psychology.

It, in a way is like if Criminology as a field was instead written by those who were criminals describing their own thought patterns without critique and trying to sell their own thinking patterns as normal by using manifestos and fallacial linguistics to pretend those who don't think like them are the strange ones and those hurt by them are 'the cause of their own pain for letting it hurt them'. It would be interesting to see and insight but wouldn't necessarily be a treatment without some sort of order from e.g. scientific rigour and oversight.

It is a shame because when you think about it there are probably many areas of psychology and illnesses under the mental health and cognitive area where actually having them run, led-by and being the writings of those who actually have or have experienced the condition would probably move it forward leaps and bounds rather than keeping it in a dead-end rut of paternalism. So you have this irony of the 'kept out' being utterly the wrong way around for this larger field often.

I don't know quite what you do when technically an area is 'a psychology' but 'not 'Pyschology'' and whether it should still exist as a field - but with remits and limitations that require it to be audited and kept in the science sense - or whether it is almost like a historical artefact of 'this is how some people were allowed to think'. There are a few other examples of such dangerous subjects (like eugenics, propaganda and there are probably lots of other isms, ogynies etc) where smaller groupings still are kept for whatever reason with tenured people 'researching' so there must be seen as 'academic worth' or it just being about academic freedom or something. But culture and society seems to keep these more bound and limited to being a 'marvel at' type entity.

But I read this certainly as nothing about the 'pretend subject/aka patients' and all about post-hoc justification/aka selling of the self-interest of whoever the individuals writing this are representing/with, and their psychology and delusion. So yes a useful historical document for one day when hopefully there will be an entire area devoted to the 'never again' and 'how did this happen' and 'how can we prevent such distorted thinking'.

 

Precisely it. And only gets worse because you'd have to be self-flagellating given the requirement for literature reviews etc to, even if you could produce research that required 10x the time given (because timescales have been tallied to doing not-proper designs), you'd have few other papers to back you up and be going against 'names' who would read through your thesis looking for any old excuse to mark you down simply because (and that is particular to the sensitive types in this area of psychosomatic) they can't take people disagreeing with them/criticism.

That's a culture issue. Such a subject shouldn't be existing as it does. I'm sure there is a little bit of this in other areas, but less dominance of 'follow the hierarchy or don't get through' in other subjects, and more allowance for open-thinking and indeed critical analysis and evaluation is what academic anything is supposed to be in most other marking schemes. It feels like a QAA issue.

 

Nope sadly as someone with an actual psychology degree I've watched as people from any other background than scientific psychology has decided to wonder themselves into coaching or 'brainwashing techniques' (CBT is just a delivery mechanism and someone with a qual in that isn't qualified to know whether what they are brainwashing in is healthy or of any use, just how to 'make it happen'). It isn't the older, proper scientific psychology that is at issue here - but the 'transformed' de-skilled version that came with the 'mental health, CBT, IAPT' type thing. And out went the oversight of actually diagnosing people precisely and matching treatments in the specific (vs the preference of the medicine side to generic programmes because everyone just needs to generically think better they pretend is mental health).

Those trained learn the spiel and the hubris (although I think to wander into it with no more than a few days nonsense course in 'pretend CBT, but it was actually more NLP about communication and making other people say things you want them to say') and are then basically empty. In fact the less deluded and more itsy bit of intelligence they have left then at least they feel awkward when they realise I have a degree in psychology and are respectful enough to shut their cakeholes down. The real dumbasses you can see in their mind half-hearing you say that (vs their arts degree) and then sea-lioning with some nonsense phrase like 'but people with hydrochondria do exist, we all know one don't we'.

This business area has just boomed because it has given some people a license to think they've something to offer other people. And its the vulnerable and hard on their luck because of being badly treated by others that get chucked under them because support networks have been deconstructed by ideas 'all such people should be sent to mental health' and then weedle away with manipulation trying to ferret for a justification for their parastic behaviour. Some of them have ended up there because they've had the same done to them and the misogynistic society has said that is the only path that is left for them: they can have an OK life if they agree to be part of the system doing it to others who haven't yet been persuaded of it, and they believe it because 'look at them now making a living from doing the coaching'.

I highly doubt those behind all of this are proper, decent, scientific psychologists with training in the cognitive and biological and perception-based science. They'll be at best psychiatry-type area who wondered in free to make their own analyses based on literature written in some cases by Freud and all of which not scientifically tested but at best based on the 'inference' medicine believes to be science (but luckily for other areas of medicine does get backed up by the observation involved with deductiion because, well, there are body-parts to measure).

But more likely people who've been taught 'embedded' communication techniques like CBT and so think they know psychology but really have just got a differently-named version of the hard-sales courses someone in recruitment or sales would get. Along with sadly getting a bigoted mindset programmed in by being told a few rumours of personality based on fake associations in dodgy research. But definitely never the critical thinking for them to see wood-for-trees on those. Scientific psychology knows personality research is flawed and how the Big 5 is as accurate as you are going to get at explaining personality, which they researched in order to demonstrate 'how little' and keep a lid on the 'pretend characteristics like perfectionism' nonsense. That one isn't even internally consistent given any man on the street will describe someone/thing entirely different for that tropey term (one will be the slack woman who likes pretty pens at the start of term, another will be the person who is just very good at their job).

Just like the cliche of 'the person that you should give the most power to is the one who least wants it', noone who genuinely cared and was interested in the mental health of others and understanding psychology proper would be going around calling people perfectionists and spouting this tosh. A respectable psychologist would never jump to conclusions labelling an acquaintance at a dinner party by some pseudo-psych term either if they were responsible and so on. These are just little rabbles of people who gossip about 'maybe people like that act this way because....' and then don't realise you are supposed to fill that gap with deep, proper scientific research instead of them gaggling up and brainstorming top-of-the-head ideas based on their own internal not-very-nice ideas of others (then thinking a little leading survey proves it).

 

yes it's a complete failure of logic.

 

Apologies for just popping in -- thought the connection to EURONET-SOMA was interesting:

Acknowledgments

The PSY-PSS framework was inspired and influenced by the scientific exchange within EURONET-SOMA, the European Network to Improve Diagnostic, Treatment and Health Care for Patients with Persistent Somatic Symptoms (https://www.euronet-soma.eu/).[...]

At least two authors seem to be members of the EURONET-SOMA group -- see thread here.