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Mental health screening in adolescents with CFS/ME, Loades, Crawley et al, 2021

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Feb 9, 2021.

  1. Andy

    Andy Committee Member

    Hampshire, UK
    Open access, https://link.springer.com/article/10.1007/s00787-021-01734-5
  2. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

    Yes, that's right. Dumb it down even further so you can misinterpret the results of inappropriate questionnaires some more.

    Let's make it simpler & easier for the clinical team, probably by adding another layer of abstraction between what they're meant to be assessing and they're interpretation.

    Let's not investigate the accuracy and how appropriate those screening "mechanisms" are.

    Let's focus on making life easier to slap labels on young people.
    MEMarge, Hutan, EzzieD and 7 others like this.
  3. Snowdrop

    Snowdrop Senior Member (Voting Rights)

    I have a question for anyone who might know, is there a specific way of defining depression within the health care service? It would be good to have that as a reference to all of this.

    And yes, instead of continuing work on labelling children so much needs to be done that comes before that (understanding the biology of depression etc). This has all been way oversimplified.

    And how does one account for normal differences in functioning (one's innate characteristics when interacting with the world)?

    There are many more of this kind of observation to make but none of these are specific to only this study. Can any meaning at all be derived from studies that are so imprecise? And what does that mean for attempts at treatment?

    Also, in their own words:

    They would seem to be more cautious in their claims than in the past?

    But I feel like I've said this all before (long ago). My POV is that this is all money down the drain.

    I also continue to be surprised that EC can find new victims. But I guess the pandemic has offered new unsuspecting subjects.
    Invisible Woman, alktipping and Andy like this.
  4. rvallee

    rvallee Senior Member (Voting Rights)

    The exact same process behind the 1/5 with Covid experiencing "mental health" symptoms:
    1. Patients present with many symptoms
    2. No tests exist for symptoms
    3. Symptoms are dismissed and instead marked as either of: fatigue, anxiety or depression
    4. Trawl through medical records and find many mental health "diagnoses"
    5. Use questionnaires that deliberately conflate illness with depression
    They literally misdiagnose people then use their own misdiagnosis as evidence that the misdiagnosis was right. As is tradition. This is beyond dysfunctional. And this is at least the 50th or so study doing the same thing. Copy-paste research.

    These people whine about the danger of medical labels yet apply dozens of psychological labels with complete disregard for validity because the labels are so vague and ambiguous they apply in almost any case you want to. The more labels the better. What garbage.
  5. Sean

    Sean Senior Member (Voting Rights)

    No denying they are experts at something. Pity it is bootstrapping and gaslighting.

    I still find their shameless blatant hypocrisy breathtaking.
    Hutan, alktipping, rvallee and 4 others like this.
  6. Amw66

    Amw66 Senior Member (Voting Rights)

    This from the team which failed to acknowledge dysautonomia for years ( which is commonly misconstrued as anxiety) , and whose comprehension of PEM is primary school level. ( that's being generous)

    A common theme on parents forums from interaction with the Bath team is them not listening to the kids ( seems to be a preferred tick box of symptoms). Anecdotally a fair number of kids feel they have failed when going through the Bath protocol. I'm sure that does wonders for mental health

    Oops , is there a correlation there ?
    Hutan, alktipping, Simbindi and 9 others like this.
  7. arewenearlythereyet

    arewenearlythereyet Senior Member (Voting Rights)

    I am definitely no expert on this but I did receive a “score” for depression and anxiety as part of my formal diagnosis at the CFS clinic here in the U.K.

    just dug out my report and it refers to a “hospital anxiety/depression scale” which has the following range “normal range 0-7, action range 13-21”

    I scored anxiety 6, depression 8 and also a 6 on an Epworth score (whatever that is) so this was the proof they used that this wasn’t the cause of my symptoms/CDC score.

    I can’t recall the type of questions asked ...sorry it’s a bit blurry looking back. I’ve dug out what I could find on “HADS” via google here:


    Basically you get a score of up to 3 points for each question and there are 7 questions for depression and 7 for anxiety ..the higher the score, the more you are likely to have the condition. Looks like NICE still use it but it has been criticised I believe.

    Looks like the Epworth score is about diagnosing sleep disorders (narcolepsy, sleep apnoea etc).
  8. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

    I would like to make a research proposal.

    Assuming they were able I'd like to go through the questionnaires with the young people as they answered them.

    Let them

    A) answer it as they would,
    B) discuss what they think each question means and why they answered in the way the did and record that.

    Then let Crawley et al make their usual interpretation, diagnosis and comments based on A and have someone independent & with no axe to grind make comments and diagnosis based on B.

    It would be interesting to see just how off far off the mark Crawley et al are. We could the draw up a measurement scale for that. Now what to call it?
    EzzieD, Hutan, Sean and 7 others like this.
  9. Adrian

    Adrian Administrator Staff Member

    There is a surprise - this is why others have for many years said its shouldn't be used. Coyne called it the Elvis scale (long deseased but still sightings or to use his pun citings) and that was 2012 so 9 years later .....
    EzzieD, Hutan, Sean and 6 others like this.
  10. arewenearlythereyet

    arewenearlythereyet Senior Member (Voting Rights)

    Blatant Manipulation bias?
  11. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

    Interesting looks like some serious problems for the HADS.

    The sensitivity/specificity criteria were not that high (0.8 and 0.7) and they simply looked at depression or/and anxiety so the questionnaire didn't have to differentiate between the two. Nonetheless, the HADS failed to obtain the required sensitivity and specificity.

    In other words, it does a poor job at screening ME/CFS patients who might have depression and/or anxiety.

    Here's an online version of the scale: https://www.svri.org/sites/default/files/attachments/2016-01-13/HADS.pdf

    It asks questions that only relate indirectly with depression or anxiety such as "I feel as if I am slowed down" or "I can enjoy a good book or radio or TV program"

    I wonder how well the question "Do you have anxiety and/or depression?" would do on a screening test like this. That should be like a control condition that other questionnaires have to beat in order to be taken seriously.
    Snowdrop, Dolphin, MEMarge and 5 others like this.

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