1. Guest, to read the 'News In Brief' from w/c 18th June, just click here.
    Dismiss Notice

Medically unexplained syndromes: irritable bowel syndrome, fibromyalgia and chronic fatigue (2018) Luty

Discussion in 'PsychoSocial ME/CFS Research' started by MeSci, Jun 12, 2018.

  1. MeSci

    MeSci Senior Member (Voting Rights)

    Messages:
    779
    Likes Received:
    5,013
    Location:
    Cornwall, UK
    Source: BJPsych Advances

    Preprint

    Date: June 6, 2018

    URL:
    https://www.cambridge.org/core/jour...onic-fatigue/056188C35015F793F283E6F385386289

    Medically unexplained syndromes: irritable bowel syndrome, fibromyalgia and chronic fatigue
    ----------------------------------------------------------
    Jason Luty

    - Liaison Psychiatry, Farm Lodge, C/O Bradgate Unit, Glenfield Hospital, Groby Road, Leicester LE3 9EJ, UK. Email: jason.luty@yahoo.co.uk

    Abstract

    This is a review of three of the more common medically unexplained syndromes that present for treatment to liaison psychiatry services in general medical hospitals: chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome. The three are interrelated, extremely
    disabling and comorbid mood disorders are frequent. In general, treatment, whether psychological or medical, has very modest impact. The disputed classification of medically unexplained syndromes is also reviewed. There is a clear gulf between the views and experiences of patients with these syndromes and the medical establishment. In this article I summarise give the evidence for pharmacological, psychosocial and 'alternative' or 'complementary' interventions for a range of disorders, about which there is some dispute. I leave it to the reader to decide which interventions hold the most promise.

    --------
    (c) 2018 The Royal College of Psychiatrists
    (c) 2018 Cambridge University Press
     
    Inara, Joh, Simone and 1 other person like this.
  2. Lidia

    Lidia Established Member (Voting Rights)

    Messages:
    56
    Likes Received:
    379
    Some editing wouldn’t have gone astray Jason Luty.
     
    Hutan, JaimeS and Tia like this.
  3. Tia

    Tia Established Member (Voting Rights)

    Messages:
    38
    Likes Received:
    401
    Typo in the abstract is not good is it?!
     
    Hutan and JaimeS like this.
  4. cyclamen

    cyclamen Established Member (Voting Rights)

    Messages:
    44
    Likes Received:
    142
    Inara likes this.
  5. ladycatlover

    ladycatlover Senior Member (Voting Rights)

    Messages:
    307
    Likes Received:
    2,365
    Location:
    Liverpool, UK
    Hutan likes this.
  6. strategist

    strategist Senior Member (Voting Rights)

    Messages:
    550
    Likes Received:
    5,674
    It ends with
    It also acknowledges the poor long term followup results in PACE, and reports the recovery outcomes from the PACE reanalysis. Unfortunately it doesn't make clear that this was the analysis as originally planned or that there were no statistically significant differences between groups.

    Anyway, the PACE criticism is slowly getting into the literature.
     
    Last edited: Jun 12, 2018
    Tia, Sly Saint, Hutan and 13 others like this.
  7. alktipping

    alktipping Senior Member (Voting Rights)

    Messages:
    160
    Likes Received:
    797
    where is the actual review part of this paper.
     
    Trish likes this.
  8. Trish

    Trish Moderator Staff Member

    Messages:
    4,211
    Likes Received:
    27,750
    Location:
    UK
    Thanks @strategist - do you have a link so we can read the full article?
     
    alktipping likes this.
  9. strategist

    strategist Senior Member (Voting Rights)

    Messages:
    550
    Likes Received:
    5,674
    alktipping and adambeyoncelowe like this.
  10. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

    Messages:
    1,623
    Likes Received:
    18,663
    This looks like a muddled review by a junior doctor who has not himself quite worked out what he wants to say. It mentions some of the issues patients have with treatments but makes no constructive analysis. The account of PACE is still woefully inaccurate.

    This reminds me that maybe ME advocacy should be deliberately targeting very young professionals and students in medicine and allied professions (therapists). These are the people who may still have an open mind about what they should be doing. Judging by this they may see some of both sides and be uncertain. They need to hear loud and clear that the studies of treatments are simply not informative because they are too badly designed.
     
    alktipping, ukxmrv, Tia and 6 others like this.
  11. Trish

    Trish Moderator Staff Member

    Messages:
    4,211
    Likes Received:
    27,750
    Location:
    UK
    I think the conclusion is interesting:
    Edit: I mean in the sense that he does at least question the psychological approach.
     
    alktipping, Tia, Lidia and 3 others like this.
  12. NelliePledge

    NelliePledge Senior Member (Voting Rights)

    Messages:
    932
    Likes Received:
    6,914
    Location:
    UK East Midlands
    Interesting clearly he didn’t give this person a feeling of being empathised with. Maybe if you have doubts about what you’re having to say to people that makes it harder to show empathy because you have to make yourself more of a robot to do it. My IAPT CBT person was quite robotic and I put it down to the process rather than her personally. I did get the feeling she was not comfortable being a sausage machine operator.
     
    alktipping likes this.
  13. NelliePledge

    NelliePledge Senior Member (Voting Rights)

    Messages:
    932
    Likes Received:
    6,914
    Location:
    UK East Midlands
    I see his email is a yahoo rather than an NHS address. Maybe he is contactable on that still and would be interested in joining S4ME???
     
    alktipping likes this.
  14. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

    Messages:
    1,623
    Likes Received:
    18,663
    What seems odd is that he has picked up from the PACE follow up that there was no long term benefit yet that is not how the paper he quotes presents it at all. And he seems oblivious to the much more obvious problems with the original PACE results - not just the re-analysis but the uselessness of the trial design.

    Perhaps this was all he felt he could say without losing his job. Maybe he overdid it as it is!
     
    alktipping, MeSci, Tia and 2 others like this.
  15. Trish

    Trish Moderator Staff Member

    Messages:
    4,211
    Likes Received:
    27,750
    Location:
    UK
    I think he has done a very superficial overview - he keeps referring to 'chronic fatigue' instead of CFS, quotes whole chunks of the NICE guidelines, doesn't refer at all to the methodological flaws in PACE, and only seems aware of Oxford and Fukuda criteria ...
     
    alktipping and Tia like this.

Share This Page