MUS services in UK and other MUS related issues

NelliePledge said:
Disrespect due to not believing the patients. So much easier to judge people if you think they are deliberately not helping themselves by following your approach. non compliant due to ‘Unhelpful beliefs’ or downright malingering[/QUOTE

True. But I meant more what's behind that in terms of this being systemically validated. I see I wan't really clear on that. Some Dr's may always tend to find that easier to believe but the system is now validating that belief.
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Yes because the BPS contingent are going around doing conferences and training courses and have persuaded the NHS hierarchy of its cost saving benefits. IAPT CBT as a panacea. That’s why the BPS are continuing to defend PACE and engaging in this latest round of negative publicity.
 
NelliePledge said:
Yes because the BPS contingent are going around doing conferences and training courses and have persuaded the NHS hierarchy of its cost saving benefits. IAPT CBT as a panacea. That’s why the BPS are continuing to defend PACE and engaging in this latest round of negative publicity.
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Maybe.

I actually hope that it's driven merely by the idea that it saves money as that can be argued against realistically. But I have some niggling sense that there is more to it and that reasonable debate will not move the opinions at all.

And how do they get so many people to believe something about the nature of MUS that is so at odds with reality?
 
NelliePledge said:
Yes because the BPS contingent are going around doing conferences and training courses and have persuaded the NHS hierarchy of its cost saving benefits. IAPT CBT as a panacea. That’s why the BPS are continuing to defend PACE and engaging in this latest round of negative publicity.
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Eventually the numbers are going to come out and they will fall very short of the absurd promised 50% "recovery", even with the usual dumbing down, cherry-picking and redefinitions of common terms they managed to make standard in psychosocial research.

Overpromise, fail to deliver. That's a combination that inevitably crumbles under its own weight. The only question is how much resources and lives they waste until reality catches up to their pipe dream.

There was no cost saving, only the delusion of. Like cutting taxes and claiming it will raise revenue. Numbers can be kept hidden for a while and bad news dismissed as fake and incomplete, but only for so long. This would probably be discussed much more if it wasn't for the trashing T-Rexit occupying all the political mental space in the UK.
 
Snowdrop said:
And how do they get so many people to believe something about the nature of MUS that is so at odds with reality?
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The idea that the mind can magically cure illness is really, really intoxicating to some. It's like The One Ring or the Philosopher's Stone. Magical thinking is still common, even in highly educated professionals. It's hard to let go of this, it promises too much (which is the first clue that it's too good to be true but that rarely stops anyone).
 
EAPM2019 19-22 June, Rotterdam

7th annual scientific conference of the European Association of Psychosomatic Medicine • EAPM •
Integrating psychosomatic care across medical settings and specialties Rotterdam (The Netherlands),
19 - 22 juni 2019 Postillion Convention Centre WTC Rotterdam

Full programme PDF: https://www.eapm2019.com/stream/eapm-2019-programma-boek-versie-16-6-def2.pdf


Keynote lecture: The psychosomatic dream of integrated mental and physical care: only a dream? M. Sharpe (Oxford, UK); Andreas Schröder; Richard D. Lane, M.D., Ph.D. https://www.eapm2019.com/cms/showpage.aspx?id=3888

Program: https://www.eapm2019.com/website/program/program

Wed June 19: https://www.eapm2019.com/website/program/preconference/joint-aclp-eapm-preconference-on-pathophysiological-considerations-in-psychosomatic-medicine

Thurs June 20: https://www.eapm2019.com/website/program/thursday/eapm-main-conference-thursday-june-20th-2019

Fri June 21: https://www.eapm2019.com/website/program/friday/eapm-main-conference-friday-june-21st-2019

Sat June 22: https://www.eapm2019.com/website/program/saturday/eapm-main-conference-saturday-june-22nd-2019

Research lecture: A European research agenda for Somatic Symptom Disorders(SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) on behalf of EAPM: where do we go from here?
 
This year's Allison Creed Award Winner is Else Guthrie (Leeds, UK) Design of randomised controlled trials of interventions for people with persistent physical symptoms.

Previous Allison Creed Awards have been presented to Michael Sharpe and Per Fink.

(Allison Creed is the late wife of Emeritus Prof Francis Creed. Prof Creed was a key member of the ICD Revision S3DWG subworking group that developed the ICD-11 Bodily distress disorder diagnostic category; Prof Creed had also been a member of the DSM-5 SSD Work Group and former member of the editorial board of the Journal of Psychosomatic Research.)

The Journal of Psychosomatic Research is the publishing organ of the EAMP (European Association of Psychosomatic Medicine) that is hosting this symposium.


Although he had been a member of the DSM-5 SSD Work Group, Prof Creed does not like the SSD term or the SSD construct, himself; he prefers the Fink et al (2010) BDS construct and the name "Bodily distress disorder" or "Bodily distress syndrome". But the BDD construct that ICD-11 has developed is closely aligned to DSM-5's SSD, which must be a great disappointment to Creed.

I suspect it is largely Creed's influence that drove the (now sunsetted) ICD-11 S3DWG subworking group to persist with the "BDD" name despite the fact that as described and characterized for ICD-11, BDD has greater conceptual alignment with the DSM-5 SSD construct, but is re-purposing a disorder name historically closely associated with a differently conceptualized diagnostic construct.

May 6, 2019:

World Psychiatry

https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20635

Fuss, J. , Lemay, K. , Stein, D. J., Briken, P. , Jakob, R. , Reed, G. M. and Kogan, C. S. (2019)
Public stakeholders’ comments on ICD‐11 chapters related to mental and sexual health. World Psychiatry
18: 233-235. doi:10.1002/wps.20635 https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20635

"A majority of submissions regarding bodily distress disorder were critical, but were often made by the same individuals (N=8). Criticism mainly focused on conceptualization (48%; κ=0.64) and the disorder name (43%; κ=0.91).
Use of a diagnostic term that is closely associated with the differently conceptualized bodily distress syndrome5 was seen as problematic. One criticism was that the definition relies too heavily on the subjective clinical decision that patients’ attention directed towards bodily symptoms is “excessive”. A number of comments (17%; κ=0.62) expressed concern that this would lead to patients being classified as mentally disordered and preclude them from receiving appropriate biologically‐oriented care. Some contributors submitted proposals for changes to the definition (30%; κ=0.89). Others opposed inclusion of the disorder altogether (26%; κ=0.88), while no submission (κ=1) expressed support for inclusion. The WHO decided to retain bodily distress disorder as a diagnostic category6 and addressed concerns by requiring in the CDDG* the presence of additional features, such as significant functional impairment."​


*The CDDG is the Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD‐11 Mental, Behavioural and Neurodevelopmental Disorders (the ICD-11 equivalent of ICD-10's "Blue Book"). It hasn't been released yet, although I have had sight of a 2016 draft.

The CDDG guidelines expand on the brief Description texts in the ICD-11 MMS and include the "Essential (Required) Features, Boundaries with Other Disorders and Normality, Additional Features sections, Culture-Related Features."

[Edited to expand extract.]
 
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Trish said:
Thanks for those links, @Dx Revision Watch. More evidence that M. Sharpe and his cronies march on regardless. How utterly depressing. :(
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IAPT, PPS, MUS services (UK); FDs, BDS (Denmark and beyond); EURONET-SOMA* (European Network to improve diagnostic, treatment and health care for patients with persistent somatic symptoms); Sharpe et al...like trying to hold back the tide.

I note some U.S. academics asserting on Twitter that the tide is beginning to turn in the UK and EU; I see no concrete evidence that things are improving.

*EURONET-SOMA
https://www.euronet-soma.eu/information/about-euronet-soma/
 
Dx Revision Watch said:
Keynote lecture: The psychosomatic dream of integrated mental and physical care: only a dream? M. Sharpe (Oxford, UK); Andreas Schröder; Richard D. Lane, M.D., Ph.D. https://www.eapm2019.com/cms/showpage.aspx?id=3888
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More like a nightmare. The idea of mixing together two mutually exclusive concepts, one literally defined by the absence of the other, is completely insane.

It seems that a good guide for competent and humane health care is basically to reject everything Michael Sharpe thinks is a good idea. The man has a natural talent for being wrong about the most fundamental things, it's almost supernatural.
 
Dx Revision Watch said:
7th annual scientific conference of the European Association of Psychosomatic Medicine • EAPM •
Integrating psychosomatic care across medical settings and specialties Rotterdam (The Netherlands),
19 - 22 juni 2019 Postillion Convention Centre WTC Rotterdam
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Someone posted an unofficial video of M. Sharpe. It's lasting only a few minutes, but is nonetheless quite interesting.



Here is the transcript:

… a lovely book in 1912 by a man called Jamieson Hurry, called “The Vicious Circles of Neurasthenia”. And it's a book of little diagrams really that he drew [?] going from mind to body and back again. And I think we have some very interesting examples of how you can beget an illness and then the behavior you adopt serves to perpetuate the illness.

So I guess... do we need to think about a different paradigm? Should we be thinking about psychosomatic illness which, was the old idea, asthma so on... were psychosomatic illnesses. The other illnesses weren't [?] Or should we be thinking about psychosomatic medicine?

And I thought the talks this afternoon were really interesting in putting these mechanisms into context. And the context is “it's complex” and the probably all symptoms have a psychological aspect to them. So that's a shift, isn't it? And then you take this even further and we're here about IBS and aout (dizzyness?). And we get a kind of figure ground flip here, because it used to be... there was all those diseases out there and we are people, you guys here, that were interested in this psychosomatic stuff. And suddenly, we realized “no we're the normal people [?] most illnesses that people have are not based on disease. Disease is actually the minority sport. Disease is very important in turning mortality but determining morbidity in the population disease is less important than the illnesses that are driven more predominantly by these other factors.

So I think maybe we need to be thinking a lot of hints today about how we change paradigm and then a thing for research that's going to mean, as we're hearing today, they're fantastic presentations. Neurologists and psychiatrists, endocrinologists, so we've actually got to take a more joinder view. The idea we can just have psychologists and psychiatrists when it comes to anything (like medical conditions study?). We're gonna have to be mixed together, we're gonna have to have a joined-up approach and psychosomatic meaning body and mind, psychology and other biological factors, are the way to go.

And I think the same is going to be the case for clinical teams. And when you think about obesity and about diabetes and about this [?] disease, you see some wonderful examples of how we can have to put together what used to be called psychosomatic and what used to be called medical. So I think this is a really exciting time, I think this has crystallized well today. We're on edge (an age?) of thinking about these things in a completely different way. And as Judith said, you know a lot of the ways we think about these, we have to change the way that, we, under the doctors, think about illness. And rather just think there's a lot of normal patients and a few weird patients out there, there's probably just a lot of weird doctors out there including us.

Okay, any questions I provoked, any thoughts and [?]
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Cheshire said:
Someone posted an unofficial video of M. Sharpe. It's lasting only a few minutes, but is nonetheless quite interesting.



Here is the transcript:
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This word salad is the incoherent ramblings of a very confused mind. WTH is wrong that this mad-hatter is taken seriously? He should be a patient of his own nonsense, not in a position of authority to promote weird snake oil. Shame on anyone who takes this guy seriously. You should know better.
 
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