Prevalence and Treatment of Chronic Fatigue Syndrome/ME and Co-morbid Severe Health Anxiety, 2019, Daniels et al

Merged thread - paper now published.

(Definitely not a recommendation)

(Yes, this is Jo Daniels of "shopping bags" fame and a member of the NICE committee)

https://www.sciencedirect.com/science/article/pii/S1697260019302479
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a debilitating condition that affects 0.2–0.4% of the population. Health focussed anxiety is common across medical conditions, and may be relevant in CFS/ME. This study sought to identify the prevalence and impact of health anxiety (HA) in CFS/ME and evaluate the effectiveness of Cognitive Behavioural Therapy for HA in CFS/ME. Cross-sectional questionnaire methods and case-series design were used to achieve study aims. Analysis indicated that 41.9% of the CFS/ME clinic sample experienced threshold levels of health anxiety, which was associated with elevated symptom severity across several dimensions. Stepwise multiple regression indicated physical functioning and depression accounted for 23.8% of variance in fatigue; depression, fatigue and HA, accounted for 32.9% of variance in physical functioning. Large effect sizes and clinically significant changes were generated in the treatment study. HA is common in CFS/ME and likely to exacerbate fatigue and physical functioning. This study identifies HA as an important target for treatment, trial findings should be further replicated on a larger scale.
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This essentially describes the current model, it just phrases it slightly differently. So the current paradigm is convincing evidence but also should be examined for the first time ever (actually the 50th or so).

The conclusion is particularly egregious:
This is the first study to robustly examine prevalence rates of health anxiety in CFS/ME, acting as a larger scale replica of previous studies by the same group. Outcomes from both the prevalence study and treatment trial make a novel contribution to the current understanding and treatment of health anxiety and co-morbidity in CFS/ME. This study provides a clear rationale and platform for further research to replicate and enhance treatment options to this clinical population. Screening for comorbidity is strongly recommended.
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This is not the first study of exactly this, in fact there probably are at least two dozen identical ones. It literally is the current paradigm, so the suggestion that this is the first study is specutacularly wrong and ignorant. It's still not actual evidence of anything, this is pure cherry-picking and outcome-seeking.

The confused comparisons with depression essentially amount to an ecologist who insists that elephants and rocks are essentially the same thing since they are both hard and grey. Experts are not supposed to be confused by superficial similarities. Or they could sit on an expert panel for the topic they display blatant ignorance. Both work, I guess.
 
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It's notable that this level of incompetence and willful ignorance should be as disqualifying as an expert arguing for the "refrigerator mother" model of autism should be disqualified on the topic of autism, or even anything, really.

Not that this will make any difference but it truly reflects the massive incompetence at NICE that this person was accepted on a panel despite showing blatant confusion and misunderstanding of pretty much everything, including it seems the entirety of the last 30 years or even what is the current paradigm.
 
Trish said:
Fukuda criteria used, high proportion with comorbid depression and/or anxiety. No mention of how many if any had PEM. I don't believe the patients who apparently improved so dramatically on CFQ and SF-36 PF in so short a time had ME.
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I genuinely believe that a combination of 1) questionable intellectual capacity and 2) self preserving incentivisation/cartel behaviour across the BACME BPS cabal means these people are not going to absorb the points you raise.

We rightly cannot receive comment from within NICE deliberations. But if matters are properly considered to their logical conclusions, I cannot see how reference to research of this embarrassing calibre by Daniels et al would not result in their actual humiliation. It's not the objective, of course, but I've seen academic presentations result in extreme blushes and even hidden tears for much less.

I am not trying to be obtuse, but there is no space for the committee to suffer fools. I do hope that punches are not pulled - pwME would end up suffering to massage/protect egos. I hope that decorum is not an overriding arbiter of any discourse.
 
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rvallee said:
Yes, this is Jo Daniels of "shopping bags" fame and a member of the NICE committee
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I'm full of admiration for the S4ME members who are serving on the NICE committee with Jo Daniels. I think if it was me, I might have a lapse of professionalism and 'inadvertently' have the plastic bag scene from American Beauty playing as I went to share a draft on screen. Or something a whole lot more overt.
 
One wishes to be careful in what one writes, but Jo Daniel's views on health anxiety may be coloured by her own experience. There were recent reports on the BBC about a call for more male blood donors. The photograph seemed to match. It is a most unfortunate situation. Apparently the iron content of male blood can be of significance.
 
Hutan said:
I'm full of admiration for the S4ME members who are serving on the NICE committee with Jo Daniels. I think if it was me, I might have a lapse of professionalism and 'inadvertently' have the plastic bag scene from American Beauty playing as I went to share a draft on screen. Or something a whole lot more overt.
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S4ME shopping bags, what a great idea.
(seriously, they're not that expensive [non-plastic]):)
 
I fail to understand how "Bags" Daniels or anyone else who has had contact with anyone with ME (apart from the very mildest and most recent onset) doesn't learn the opposite is true.

Most of us are too sick to interact much with the NHS at all. They tend to make it difficult. I know I have put off getting things checked out and I doubt I'm alone in that.

A GP has actually said to me - we haven't seen you for ages.... Or nag about going to breast clinic assessments, smear tests, blood tests that I have let slide until I feel well enough to get them done & doing them won't knock me back for weeks.

Health anxiety, my rear.....
 
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