Psychiatrist Peter White at the Royal Society of Medicine 2008 - Defining CFS/ME

His guts. It's all gut feeling so that's basically the answer 99% of the time.

 

I don't remember exactly what he said. However, the implication was that whatever methods are normally used to assess psychiatric problems showed up more with people with more symptoms. Unless one denies that anyone can diagnose psychiatric problems I think that has to be taken as at least plausible. I think it is entirely plausible that people with psychiatric problems like anxiety will tend to report a wider range of symptoms.

So he may or may not be right but I don't think it should be dismissed as nonsense. Features of an illness are not necessary good diagnostic pointers. Rheumatoid arthritis can rather rarely produce rash but a rash with arthritis is generally an indication it is not rheumatoid arthritis. Devising diagnostic criteria should be based on pure statistical evidence, not on what people think is paradigmatic of the illness.

 

I have read things where it was stated as fact that the more symptoms you have the more likely you are to have a psychiatric or possibly psychological illness.

The problem with that is it may work for something easy to diagnose or with a test. If it is suspected that you have an overactive thyroid you get a blood test done and it is yes or no, so you do not have to list overheating, itches, tremors, weight loss, increased appetite, ketones on the breath, palpitations, fatigue, yellow eyeballs; all of which my husband experienced.

When you are not getting a diagnosis you keep going back to the doctor with something else you've noticed because it might be the thing that makes the doctor go "OK, got it now".

So the long list of symptoms is just as likely to be an artefact of a lack in current medical practice rahter than saying anything about the patient's illness.

 

This.

And i find it problematic that the more you desperate you get to find help, the more you try to help the doctor figure out a diagnosis by bringing up the slightest thing that 'might' be useful information, therefore you end up listing more & more symptoms/sensations that seem even slightly off because you think it might help - at least that's what i did. If i'd been given a dx sooner i wouldn't have even mentioned half the things that i did.

Conscientiousness in reporting symptoms is just that, & shouldnt be interpreted otherwise imho. The layman doesnt know whats important & what isnt, & shouldnt be (in effect) penalised for trying to help.

 

No doubt multiple sclerosis, with its multiple, varied and variable symptoms was declared psychological for the same reason, i.e. too many symptoms. Another triumph for inductive psychological diagnosis.

 

I am not sure there is much "induction" in the process. It seems to be entirely a priori.

 

The origin of both was roughly in the gut area.

Gut-feeling medicine: failing sick people since forever.

 

This video is still available here.

 

Here are the slides that went along with the presentation. I was particularly irked by his criticism of the woman in the mobility scooter