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Health Care Use and Costs of Children, Adolescents, and Young Adults With Somatic Symptom and Related Disorders, 2020, Saunders et al
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Andy
Retired committee member
It’s Time to View Severe Medically Unexplained Symptoms as Red-Flag Symptoms of Depression and Anxiety
Open access, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768562
Mithriel
Senior Member (Voting Rights)
I can't get my head round this sort of mind set. If children have a set of symptoms they need investigated. If all the wrong tests are used it will be more expensive and take longer. Looking in the wrong place will never find an answer.
The answer could just as easily lie in the diagnostic process as with mental health issues in the patient. Byron Hyde described a young patient who had blisters on her hands and in her mouth. Now I am a lay person but my next move would have been to check her feet. Instead they decided she was deliberately damaging her mouth.
Part of this is that GPs are the experts in common diseases and would have recognized hand foot and mouth disease but the hospital doctors did not. Yet enteroviruses are known to cause serious body wide disease in some children, from polio to AFM. A quick look under the covers would have ruled it in or out.
That sort of diagnostic failure is widespread and would be a better place to look than introducing psychological treatments which have a very low success rate.
I was very impressed by the paper that said mental health diagnoses should have the same level of evidence as physical diseases. Not a lot to ask.
The answer could just as easily lie in the diagnostic process as with mental health issues in the patient. Byron Hyde described a young patient who had blisters on her hands and in her mouth. Now I am a lay person but my next move would have been to check her feet. Instead they decided she was deliberately damaging her mouth.
Part of this is that GPs are the experts in common diseases and would have recognized hand foot and mouth disease but the hospital doctors did not. Yet enteroviruses are known to cause serious body wide disease in some children, from polio to AFM. A quick look under the covers would have ruled it in or out.
That sort of diagnostic failure is widespread and would be a better place to look than introducing psychological treatments which have a very low success rate.
I was very impressed by the paper that said mental health diagnoses should have the same level of evidence as physical diseases. Not a lot to ask.
Snow Leopard
Senior Member (Voting Rights)
Anyone who guessed that Robert C Smith MD is a very old white man is correct:
https://www.psychologytoday.com/au/experts/robert-c-smith-md
http://www.im.msu.edu/for applicants section/key faculty profiles/key faculty cvs/smith_cv.PDF (BS 1959, MD 1962)
"Establishing the Scientific Validation of the Biopsychosocial Model of Care" lecture:
"The Biopsychosocial Revolution" (2002):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495036/
rvallee
Senior Member (Voting Rights)
Wait, sick people seek medical care? Get out of here. That can't possibly be true, we all know that genuinely sick people don't ever do that so it's certainly right to label them as imaginary illness. QED.
I am absolutely disgusted by the people who work on this. These are children and they toy with their lives for a mediocre ideology. Medicine priding themselves on not participating in legally-sanctioned executions means nothing when they do grotesquely evil stuff like that, mentally torturing sick children. Morally this isn't any different than societies that performed ritual sacrifices. Instead of a Sun god it's the conversion disorder ideology, which frankly makes it worse considering the context.
This whole thing is genuinely the Platonic ideal of the road to hell being paved with good intentions. They think they're helping even as they are mentally and physically torturing sick children, patting themselves on the back for a job well done of... not helping whatsoever given that these sick children continue to do the thing this rotten ideology is trying to avoid: seeking medical care. This is literally spending money to hurt people while refusing to spend the necessary money to actually help them.
I am absolutely disgusted by the people who work on this. These are children and they toy with their lives for a mediocre ideology. Medicine priding themselves on not participating in legally-sanctioned executions means nothing when they do grotesquely evil stuff like that, mentally torturing sick children. Morally this isn't any different than societies that performed ritual sacrifices. Instead of a Sun god it's the conversion disorder ideology, which frankly makes it worse considering the context.
This whole thing is genuinely the Platonic ideal of the road to hell being paved with good intentions. They think they're helping even as they are mentally and physically torturing sick children, patting themselves on the back for a job well done of... not helping whatsoever given that these sick children continue to do the thing this rotten ideology is trying to avoid: seeking medical care. This is literally spending money to hurt people while refusing to spend the necessary money to actually help them.
I have no idea what that's doing here, there is no such thing as physician-delivered mental health care because it would not even be authorized or reimbursed by the national insurance system, there is a strong split between mental health and the rest of health care. There is no parity of care in large part because mental health care is so primitive as to be barbaric.
rvallee
Senior Member (Voting Rights)
That's usually the step that happens long before putting something into practice. Literally step 1 of many.
Usually. In serious professions anyway.
Snowdrop
Senior Member (Voting Rights)
That's horrifying coming from Sick Kids hospital, U of T (various dept's), and the centre for addiction and mental health.
It's very probable to me that people with unidentifiable health issues toss up on the steps of CAMH because their lives have been adversely impacted and they're struggling but that doesn't mean their primary / sole issue is depression or anxiety. Or even an issue at all.
@chrisb Who's Abbey?
Also, just want to alert @ScottTriGuy
It's very probable to me that people with unidentifiable health issues toss up on the steps of CAMH because their lives have been adversely impacted and they're struggling but that doesn't mean their primary / sole issue is depression or anxiety. Or even an issue at all.
@chrisb Who's Abbey?
Also, just want to alert @ScottTriGuy
She was, or may still be, a psychiatrist who played a prominent part in the CIBA conference andwho held strange views on somatisation. I did not think this too important until seeing in Oslers WEb that she was involved in CDC committees that scuppered various research plans. See
Somatisation, illness attribution and the sociocultural psychiatry of chronic fatigue syndrome
Susan E Abbey 1993 Chronic fatigue syndrome, Wiley, Chichester (Ciba Foundation Symposium 1730 p238-261
if you are feeling strong enough.
And she edited a book for US practitioners with Demitrack which allowed Straus to wholly misrepresent the findings of a paper by White, notwithstanding that she referred correctly to the paper in her own chapter.
ME/CFS Skeptic
Senior Member (Voting Rights)
The research article by Saunders is about "Somatic symptom and related disorders (SSRDs)". The article explains this category as follows.
Don't quite understand why they include fibromyalgia, IBS and CFS in this.
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ME/CFS Skeptic
Senior Member (Voting Rights)
The comment by Smith reads:
Which made me think: in what way are depression and anxiety better-validated disorders than ME/CFS?
They don’t have to explain do they just assert and the field expands.
Not to mention wondering just what was the point of the whole MUS/PPS/BDS/etc exercise in the first place, if the end result is simply returning back to their starting point?
