News from Scandinavia

[Midnattsol]

Littered with them most likely. Wouldn't be on my christmas wish list.

It's marketed towards healthcare students, with en emphasis on nursing students. Hope to find it tomorrow.

Edit: Found it, but it was wrapped in plastic so no reading possible. Next stop the medical library at the university.

 

[Midnattsol]

The pop-science website forskning.no (forskning = research) is having an ongoing article series on psychology research. Blurb about the series (google translate):

In a series of articles, we will focus on the field of psychology. How well does it really work?

For readers with mental health problems: In this series, we ask questions about research into psychotherapy. Several researchers speak out critically, and there is much disagreement. But the researchers agree on one thing: if you have mental health problems, there are generally better chances of recovery if you go to therapy. And if you get treatment that you feel is good for you, there is no reason to stop.

Three articles so far (I will add google translate links later when my brain works a bit better):

Hvorfor er forskerne så uenige om hvor godt psykoterapi virker?
Why are researchers arguing about how well psychotherapy works?

Kan pasienter bli like friske av å snakke med en som ikke er psykolog?
Can patients become just as healthy by talking to someone who is not a clinical psychologist?

Hvorfor finnes det 500 ulike typer psykoterapi?
Why are there 500 different types of psychotherapy?

Another post on these articles has been used to start a new thread on research methodology where the topic can be discussed further: Recipe for study that will give good results

 

[Solstice]

But the researchers agree on one thing: if you have mental health problems, there are generally better chances of recovery if you go to therapy. And if you get treatment that you feel is good for you, there is no reason to stop.

Can't read the entire articles but there's a lot to pick apart in these two sentences alone. First they prime what I suppose was to be an open discussion by saying psychology works. Generally better chances could mean anything though, could just mean that 70 out of 100 patients get a bit better while the rest get worsened for example.

The second sentence feels self-evident but is also wrong. CBT for ME/CFS can feel good. I know I enjoyed being around people that also had the disease because of the level of understanding between us. But that initial good feeling turned into tremendous worsening in the long term.

I'd imagine similarly that going to a psych that listens to you when depressed can in first instance feel good. If the psych then gives you a number of things to change about your way of thinking and you fail at that or it simply isn't good advice it can worsen your general situation.

 

[rvallee]

And if you get treatment that you feel is good for you, there is no reason to stop.

This is ridiculous in a "let's make the minimum wage $100K/h", which is meant as a joke.

If we are to believe the numbers about mental illness, and there is no reason to do so as they are obviously wildly inflated in part by making all unsolved diseases and illnesses to be mental illnesses, then even if there were 1,000x more therapists, I don't think it would be possible to meet this demand, even in the richest countries. Obviously it should stop, otherwise it's not a treatment any more than drinking alcohol daily at the corner pub is. If it doesn't treat anything, then it's not a treatment.

And even the numbers for a few sessions barely work, whose results from any rigorous studies are dismal. But the idea that people should stick to it is plain absurd, the economics don't even come close to working out.

When it comes to safe medication it can make sense to say "this works on 1/7 people so try it" because we can mass produce them. And that's if they are truly safe, which is rarely the case since side effects and discontinuation symptoms are always covered up. But to keep an active treatment going that requires 1:1 with a professional, with such terrible efficacy numbers coming out of biased studies with huge conflicts of interest, isn't just failing at economics 101, it's failing at basic common sense.

Until psychology gets serious about doing real research, they will never accomplish anything anyway. They want fake results, and that's all they're getting.

 

[Midnattsol]

Trude Schei from the Norwegian ME Association has written an opinion piece in Dagsavisen, arguing for better care systems and using Røysumtunet (we have a thread on it here) as an example to follow:

Noen betaler millionbeløp av egen lomme for å få hjelp
Some people pay millions out of their own pockets to get help

 

[mango]

ME is mentioned in this news article today about Stuart Murdoch's upcoming book, which is described as semi autobiographical.

Belle and Sebastian-sångare skriver roman om sin sjukdom
https://www.dn.se/kultur/belle-and-sebastian-sangare-skriver-roman-om-sin-sjukdom/

Belle and Sebastian singer to write novel about his illness

Stuart Murdoch, lead singer of Scottish pop band Belle and Sebastian, will release his first novel in September next year, reports music website Pitchfork.

Set in Glasgow in the 1990s, 'Nobody's Empire' follows a protagonist who is diagnosed with chronic fatigue syndrome.

The novel is described as semi-autobiographical and Murdoch himself was severely affected by the disease. For seven years he could not work because of his symptoms, but by 1995 he had recovered enough to form a band - indie darlings Belle and Sebastian.

"It felt like the opportunity was here to tell this story in longer form even though I've been singing about it for years," Murdoch said in a statement.

Chronic fatigue syndrome, also known as ME, is a neurological disorder that leaves sufferers with a feeling of exhaustion that can't be rested away. There is currently no cure for the disease, but the symptoms can be alleviated medically and through proper disease management.

Belle and Sebastian’s Stuart Murdoch to Publish Debut Novel
https://pitchfork.com/news/belle-and-sebastians-stuart-murdoch-to-publish-debut-novel/

 

[mango]

Postcovid- webbinarium för allmänläkare, 27 September

https://www.akademisktprimarvardsce...talog/postcovid--webbinarie-for-allmanlakare/

Post-Covid webinar for general practitioners

2023-09-27 13 - 15
Digitally via Teams

Academic Primary Care Center invites you to a repeat of this spring's appreciated webinar for the care of patients with postcovid in primary care.

From the program: current knowledge, investigation and possible treatment of cardiovascular dysautonomia and what rehabilitation can help.

Course date and time
September 27, 13-15
Register no later than September 20

Course content
Current state of knowledge Cardiovascular dysautonomia after COVID-19, assessment and possible treatment in primary care. Rehabilitation in post-covid

Speakers
Per Julin Specialist physician post-covid center Karolinska University Hospital Huddinge.

Artur Fedorowski Chief Physician, Cardiologist, Karolinska University Hospital Huddinge.

Anna Rytter physiotherapist, specialist in Respiration Academic Primary Care Center and Hela Kroppen Fysiocenter.

Target group
Doctors, Specialist doctors, general medicine, resident doctors

Costs
Free of charge for health care employees in primary care in Region Stockholm.

 

[mango]

Daniel Maroti and others write about treatment for functional somatic symptoms, in an article published in the journal of the Swedish Medical Association. ME is not mentioned, but Wessley and Fink are.

Funktionella somatiska symtom och nya behandlingsperspektiv
https://lakartidningen.se/klinik-oc...matiska-symtom-och-nya-behandlingsperspektiv/

Functional somatic symptoms and new treatment perspectives
Psychodynamic emotion-focused short-term therapy has good effects

Patients with long-term so-called functional bodily symptoms are common in health care and require large health care resources, but rarely feel fully understood or helped by health care efforts. Psychodynamic emotion-focused short-term therapy has recently been evaluated in several meta-analyses with good efficacy and could complement the care offered to these patients. Psychodynamic therapy for patients with functional somatic symptoms focuses on processing stressful or traumatic life events, with a particular focus on approaching difficult and charged emotions, regulating anxiety tensions, and changing non-favourable defences (e.g. high levels of self-criticism).

Archived version:
https://web.archive.org/web/2023091...matiska-symtom-och-nya-behandlingsperspektiv/

 

[Midnattsol]

Posts on the 11 million NOK/1 million euro awarded the team at Haukeland (Tronstad) to research hypoxia and microcirculation has been moved to this thread:
Tronstad et al to investigate "Impaired microcirculation and tissue hypoxia as a possible mechanism in ME/CFS

 

[mango]

Läkemedelsrekommendation vid ME/CFS saknas
https://www.janusinfo.se/nyheter/ny...idmecfssaknas.5.123ab49718aa56e7b9d5a5b0.html

Drug recommendation for ME/CFS is missing

Published 2023-09-20

Region Stockholm's pharmaceutical committee notes that no pharmacological treatment has been shown to have a curative effect in ME/CFS and therefore there are no drug recommendations for this diagnosis. Symptom-relieving drugs for depression, pain, sleep difficulties and palpitations may be of value based on individual assessment.

ME/CFS is classified by the World Health Organisation (WHO) as a neurological disorder in the ICD but the aetiology is not known. The diagnostic code G93.3 (Fatigue syndrome after viral infection) includes ME/CFS. The fatigue and malaise must have persisted for at least six months and is often associated with a previous infection. However, some patients get sick without a clear link to infection.

ME/CFS is a diagnosis based on the patient fulfilling specific history and symptom criteria. The diagnostic criteria currently used clinically are the so-called Canadian criteria [1].

Recommendation on drug treatment is missing

The knowledge reviews published by SBU and the National Board of Health and Welfare [2, 3] state that there are many knowledge gaps where research is lacking, and many of the gaps are due to the fact that we do not know what causes ME/CFS. The knowledge reviews therefore contain no recommendations on medicines. The same applies to corresponding reviews from the USA and the UK [4, 5].

Co-morbidity with differential diagnostic conditions occurs and need not exclude ME/CF, but treatable conditions should be investigated and treated in the first instance.

ME stands for myalgic encephalomyelitis and CFS stands for chronic fatigue syndrome.

Janusinfo Region Stockholm is a non-commercial drug information service for doctors and healthcare professionals.

 

[Midnattsol]

The Norwegian ME Association is planning a survey on ME and pregnancy, and if I understood correctly also the time before and after.

 

[Ravn]

Upsetting content, both the fate of the pwME and the incomprehensibly stubborn attitude of the Danish health authorities

A few days before 47-year-old Morten Brandt died, he was lying in a room. In the dark. Every movement burned in his body. He no longer had control over his muscles and could not eat himself - or hug his two daughters.

He whispered to his wife, whom he had loved since high school, that she should call a doctor. 46-year-old Line Brandt, who knew her husband inside and out, knew very well that this meant that he really needed help.

"I call the doctor on duty, where I explain that my husband has ME/CFS. That he feels terrible, is shaking and in excruciating pain. That we need help,' says Line Brandt.

But the answer from the doctor was discouraging, Line Brandt explains. She was told that they 'didn't know about the disease and therefore couldn't help her husband'. Instead suggested to her that she 'could give him a massage or they could go for a walk'.

https://www.bt.dk/samfund/vagtlaege...-opkald-faa-dage-foer-sin-mands-doed-han-blev
https://www-bt-dk.translate.goog/sa...=da&_x_tr_tl=en&_x_tr_hl=en-US&_x_tr_pto=wapp


*********
We have made an In Memory thread for Morten here:
Morten Brandt

 

[Midnattsol]

The husband of a pwME in Norway has written an opinion piece on how their life became different than expected due to illness:

Livet sammen ble ikke som vi trodde
Life together did not turn out as we thought

"Serious illness in close relationships can end in people becoming even closer, but illness can also end in broken relationships. I am grateful that Linn Therece's way of dealing with the disease has brought us even closer if possible. We stand together, but it has required me to also acknowledge my own shortcoming. I mustn't forget what it's really about. For her, it's about everyday life where she gets the opportunity to have the best possible life and hopefully get well again. I have faith and so does she. And we are both prepared for the fact that the road ahead will not be as we think and hope either."

Note for people not Norwegian, the author is high up in the military in Norway, and the couple has had some media coverage recently for potential tax evasions. No idea if it is relevant for this opinion piece, but her illness has come up during the media coverage as living conditions etc. have been important. I want to be clear they have not been found guilty of anything, but I can see a need to explain a bit more about why they live as they do.

 

[sneyz]

the author is high up in the military in Norway

Chief of Defence(!) to be exact, the highest ranking officer.

 

[mango]

Sympathetic but paywalled article in a Swedish local paper:

Teresias liv förändrades över en natt av ME-sjukdom
https://www.smp.se/feature/teresias-liv-forandrades-over-en-natt-av-me-sjukdom/

Teresia's life was changed overnight by the disease ME

Teresia Kindstrand was highly educated, self-employed, politically active and a globetrotter. But when she was diagnosed with ME, her life changed completely. Today she is on early retirement and homebound. She needs home help several times a day and finds it difficult to go out by herself.

https://www.facebook.com/smalandspo...wcXbZfHJnFpai9qGj3T7t97RYL1dUGLdw9AcXyHFz4b9l

 

[MittEremltage]

Report on Swedish radio that a new study (Knoop) showed positive results for CBT in post-covid. It also appears that the region of Stockholm is planning a similar study for people with fatigue.

”New Dutch study shows that cognitive behavioral therapy, CBT, can be effective in reducing severe fatigue in post-covid patients. 63 percent of those who received CBT were no longer bothered by fatigue when they were followed up after six months. Researcher Elin Lindsäter, at the Gustavsberg health center in Stockholm, is planning a similar study of 500 severely fatigued patients in primary care: "It is a huge group of patients who suffer from severe fatigue."”

To report in Swedish radio:
https://sverigesradio.se/artikel/kbt-kan-hjalpa-mot-extrem-trotthet


My blogpost about it (Google translated):
https://mitteremitage-wordpress-com..._sl=sv&_x_tr_tl=en&_x_tr_hl=sv&_x_tr_pto=wapp

 

[mango]

Yet another attack/opinion piece by Hanne Kjöller on people with ME, long covid and exhaustion disorder "Harmful sick leave"

DN.se Varannan patient hade aldrig behövt sin sjukskrivning
https://archive.ph/8Y3Xs

One in two patients never needed their sick leave

[...] Conflicted doctors are being eaten up by sick leave cases. Patients are getting the wrong treatment and, in the worst case, becoming dependent on unnecessary medicines. Should this really be allowed to continue?

However, nothing is said about what should be the fundamental issue. Such as how we should address the fact that sick leave is used to solve problems other than lack of ability to work: such as dissatisfaction, bad bosses, conflicts or other stresses in life. This over-utilisation costs money and suffering. The responsibility for tackling harmful sick leave will therefore continue to be shouldered by a group of responsible doctors who have not yet given up.

Symptoms often overlap: "It's usually a mix of stress, fatigue, pain, anxiety, depression and accumulated negative life events." Diagnosis can vary between exhaustion disorder, ME and post-covid. What they all have in common, however, is that the person on sick leave tends to become more tired, have more anxiety and pain while on sick leave.

Kristoffer Domargård describes a situation where the doctor ends up spending all his working hours maintaining destructive behaviour. Conflict-avoiding doctors tend to be completely consumed by the demand for care that they themselves help to create. There are return visits to be booked, medical certificates to be extended, letters from the Social Insurance Agency and the employer to be answered. And then there is the patient who develops new symptoms - from the destructive sick leave. [...]

Excellent comment on X/Twitter:

Wrong. The major problem is that many post-infectious diseases are not recognised and taken seriously in time. They can become permanently worse before they get the sick leave they need.
Feel free to think about this cost to society.

For more updated research see video 1-7

Bateman Horne Center: Post-Exertional Malaise (PEM/PESE): Cardiopulmonary Exercise Studies, Part 3 of 7
"

SusannaD: "Fel. Det stora problemet är att många postinfektiöst sjuka inte fångas upp och tas på allvar i tid. Hinner bli permanent sämre innan de får den sjukskrivning de behövt.
Fundera gärna på denna samhällskostnad.

För mer uppdaterad forskning se tex video 1-7

Bateman Horne Center: Post-Exertional Malaise (PEM/PESE): Cardiopulmonary Exercise Studies, Part 3 of 7
"

 

[Trish]

That narrative is horrendous.

 

[rvallee]

Such as how we should address the fact that sick leave is used to solve problems other than lack of ability to work: such as dissatisfaction, bad bosses, conflicts or other stresses in life

That is just pure nonsense. And obviously false. All this shows is that the so-called experts here have no clue what they are talking about, cannot tell the difference between illness and mental health. Which makes the whole claim to expertise likely a sham. It likely means that almost all so-called mental health, described as having to do with thoughts and beliefs, is likely false. All of it, or at best almost all of it.

Looking back at the evidence of the last few years, it's far more likely that almost all of mental illness, if not truly all of it, is the product of environmental and infectious causes, with some injuries added to the mix, and has nothing whatsoever to do with psychosocial causes, only consequences. The whole biopsychosocial ideology is one of the most morally bankrupt ideologies to ever see widespread adoption. It's right there with the other horrible -isms of the 20th century.

This is especially sadistic after having adopted a policy of mass reinfections from a virus that was already known to cause chronic illnesses like this. Medicine encouraged policies that made people sick, then not only refuses to care for them, but insults the people they harmed and harms them further. This is horribly immoral. I am revolted by the people doing this, enabling it, encouraging it and covering it up.

It's really all made it clear that the problem is never "these people", it's simply people that are the problem. At its core it's the same process that made horrors like the tobacco companies lie about the harm of their product, it's no different at all. We simply have not created societies in which we care for the vulnerable, and it's sad that medicine is just as unable to do the bare minimum here. Everything and everyone is simply self-centered at its core.

 

[mango]

Daniel Maroti and others write about treatment for functional somatic symptoms, in an article published in the journal of the Swedish Medical Association. ME is not mentioned, but Wessley and Fink are.

Funktionella somatiska symtom och nya behandlingsperspektiv
https://lakartidningen.se/klinik-oc...matiska-symtom-och-nya-behandlingsperspektiv/

Archived version:
https://web.archive.org/web/2023091...matiska-symtom-och-nya-behandlingsperspektiv/

A reply to the opinion piece:

Undvik begreppet »funktionell« i smärtvården
https://lakartidningen.se/opinion/debatt/2023/10/undvik-begreppet-funktionellt-i-smartvarden/

Avoid the term 'functional' in pain management

[...] The term "functional" has different meanings along a spectrum, the extremes of which consist of a rather unproblematic emphasis on how the patient "functions" in his or her everyday life (a biopsychosocial perspective) on the one hand, to a problematic "psychiatrisation" of long-term pain on the other.. We interpret the text from Maroti et al as leaning heavily towards the latter.

A reply to the reply, by Maroti et al:

Meningsfullt skilja på »funktionell« och »strukturell« smärta
https://archive.ph/wip/TgVOZ

Meaningful distinction between 'functional' and 'structural' pain

[...] When we use the term 'functional', we do not mean that there are no biological correlates. What is missing is a demonstrable pathological tissue damage.