Michael Sharpe: Mind, Medicine and Morals: A Tale of Two Illnesses (2019) BMJ blog - and published responses

As well as those with mood disorders, general hospital patients with unexplained, disproportionate or functional somatic symptoms are of increasing interest to liaison psychiatrists.

Interesting wording.

Is there any other group of doctors that would say "patients with these particular features are of increasing interest to us"?

Perhaps cosmetic surgeons?
 
Sharpe wrote about the same topic. In the early 1990s he said that "... the need for British liaison psychiatrists to justify their existence is just as acute". [...]

"As well as those with mood disorders, general hospital patients with unexplained, disproportionate or functional somatic symptoms are of increasing interest to liaison psychiatrists." [...]

At one point he argues that the future of liaison psychiatry, will determine the survival of psychiatry as a medical discipline.
Motive.
"Thus on both sides of the Atlantic clinicians are looking for research findings to support their case."
Means.
"Their identification and appropriate treatment may be one area where cost-effective interventions could be made."
Opportunity.

And, call me old fashioned, but I thought you needed an effective treatment first, before you could do any bean counting on it?
 
"Thus on both sides of the Atlantic clinicians are looking for research findings to support their case."

Does it really need to be pointed out that this is the complete opposite of science? Anti-science.

As exemplified by their refusal to use objective measures because they don't give positive results. They are deliberately and systematically constructing an unfalsifiable model.

It is straight scientific fraud, IMHO. And very cruel.
 
Sharpe wrote about the same topic. In the early 1990s he said that "... the need for British liaison psychiatrists to justify their existence is just as acute. Thus on both sides of the Altantic clinicians are looking for research findings to support their case." [...] As well as those with mood disorders, general hospital patients with unexplained, disproportionate or functional somatic symptoms are of increasing interest to liaison psychiatrists. [...] Their identification and appropriate treatment may be one area where cost-effective interventions could be made." At one point he argues that the future of liaison psychiatry, will determine the survival of psychiatry as a medical discipline. Sharpe's promotor Richard Mayou played an important role in the liaison psychiatry and the direction it would take. Source: https://journals.lww.com/co-psychia...ychiatry_and_psychological_sequelae_of.5.aspx
OMG, @Michiel Tack, this is indeed an extraordinary find. It really explains why so much hangs on this for them.
 
I do not remember the source but I have a recollection of reading that in the shake-up of the NHS in about 1990, there was a proposal to close the Maudsley and merge its operations with Kings. There was, as one would expect, substantial, and ultimately successful, fightback. Clearly that must have involved detailed, high level, negotiations, strategic plans, cost/benefit analyses, agreements and collateral agreements as to the basis for long term funding and service provision. We know nothing of any of this.

I have thought, for a long time, that Wessely and Sharpe et al are merely a symptom of the problem and that we may never know what went on "behind the curtain", just as we will probably never know the details of how Peter Lilley came to introduce LoCascio and UNUM into the DSS.

I know. I'm a conspiracy theorist. So be it.
 
It is not conspiracy theory to believe that a lot of things go on behind the scenes and are never publicised.

Before my eyes went wonky I read the BBC History Magazine. It was amazing how many things that were headlined in the papers of the time as lies and malicious rumour turned out to be true when secrets were revealed years later. Things like Harold Wilson being watched by special branch, all strongly denied at the time.
 
It is not conspiracy theory to believe that a lot of things go on behind the scenes and are never publicised.

I basically agree with you but would like to put it another way..

It is a conspiracy theory to believe or show evidence that things go on behind the scenes. That's the very definition of people gathering evidence together of some other parties conspiring.

People conspire that's a fact.

What's happened is that the term conspiracy theory has deliberately been given a negative connotation so that often the person forming, even an evidence based, theory can be ad homed in an attempt to detract others from their content.

The police form conspiracy theories everyday as part of their normal work, that's how you investigate crimes.

There is conspiracy theory, fact, which often leads to conspiracy fact.

I am a conspiracy theorist, I am out and proud.
 
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Steve Lubet of Northwestern University and i wrote a response to Sharpe/Greco. It has been through two rounds of peer review and was finally accepted for publication yesterday. It should be out within 3-4 weeks.
Doing a formal response will have required to thoroughly read it and try to make sense of it. Now that's courage. I hope the void did not gaze back. :emoji_beer:
 
Consultation-Liaison Psychiatry: The Interface of Psychiatry and Other Medical Specialties
James A. Bourgeois, OD, MDMichael Sharpe, MD
FROM THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY

Where we are going

There are many exciting opportunities for C-L psychiatry to improve patient care. It is now clear that all sizeable hospitals must have real-time access to psychiatric consultation (whether in-person or by telemedicine). New proactive and integrated models of inpatient C-L psychiatry are increasing the field’s reach and effectiveness.
Dr Bourgeois is Chair, Department of Psychiatry, Baylor Scott & White Health, Central Texas Division, and Clinical Professor (Affiliated), College of Medicine, Texas A&M University Health Science Center, Temple, TX; Dr Sharpe is President, Academy of Consultation-Liaison Psychiatry and Professor of Psychological Medicine, University of Oxford, UK. They report no conflicts of interest concerning the subject matter of this article.
https://www.psychiatrictimes.com/ar...face-psychiatry-and-other-medical-specialties
 
"Consultation-liaison (C-L) psychiatry is a major psychiatric subspecialty that, within general medical/surgical and academic medical and increasingly in primary care settings, serves as the “tip of the spear” for psychiatry."

The "tip of the spear" that can get anyone, in the gut, even with out psyschiatric comorbidities.
 
Consultation-Liaison Psychiatry: The Interface of Psychiatry and Other Medical Specialties
James A. Bourgeois, OD, MDMichael Sharpe, MD
FROM THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY



https://www.psychiatrictimes.com/ar...face-psychiatry-and-other-medical-specialties

There are many exciting opportunities for C-L psychiatry to [insert text --- make money/increase turnover/increase profit --- ]

If you can't be part of the solution then make money out of the problem!
 
Couldn't resist skimming the vanguard's text - so, another quote:

Consultation-liaison psychiatrists will also continue to lead in many areas. These include emerging areas of medical genomics in psychiatry, the monitoring of drug-drug interactions, and the management of behavioral and cognitive syndromes with complicated attributable systemic illness causes. Consequently, C-L psychiatry has an important place at the forefront of clinical, academic, and administrative leadership for psychiatry.

Any proposals for a pseudoscience gang tattoo?

deptofmind.interior-46_custom-958f99edd883e3fafa08cddfef9ba06b6801bb39-s800-c85.jpg



From Department of Mind-Blowing Theories by Tom Gauld.

https://www.npr.org/2020/04/19/837107945/scientists-are-human-too-questions-for-cartoonist-tom-gauld
 
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Description: This webinar will discuss the dramatic changes that have significantly impacted consultation-liaison psychiatry in our health systems during the pandemic. Join in as the speakers discuss successes, challenges and key lessons related to COVID-19 and its impact on consultation-liaison psychiatric care currently and in the future.
Review innovations in care delivery and telehealth in response to the pandemic. Discuss stress first aid, psychological first and other means of supporting wellness in the setting of the current health crisis.
 
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