Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic, 2022, Engelmann et al

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

https://www.frontiersin.org/articles/10.3389/fpsyg.2022.1022203/full

 

Psychogenic hype.

 

This study was used yesterday by a psychosomatic doctor.at a postcovid congress in Germany to assert the importance of psychosocial stressors and expectations as risc factors in the development of longcovid.
The congress as a whole was not about psychosomatics.

 

So once more, they are taking the fact that patients can pretty accurately tell the seriousness of their illness, and that past illness is a good predictor of future illness, as evidence that there is no illness because, I guess, it's not possible for patients to know anything about their own illness?

That's really a clear assumption here, that patients could not possibly, ever ever, be able to tell from their current illness whether it is serious enough to be a long-term problem, that it will not simply go away, if medicine can't either. Only they can know things about our own body and subjective experience, our experience has to be validated to their perception, somehow. This is dogmatic orthodoxy. Insane stuff for something as important as healthcare.

When actually what keeps showing up is that patients are generally pretty good at this. It depends on the circumstances of course, but when the illness is that clear and disabling, it's pretty easy based on symptoms. Just the same as people can look at a very darkening sky filled with lighting and predict that it's going to rain soon without having any knowledge of the fluid dynamics that go into weather prediction. But medicine doesn't take symptoms seriously, only disease, so in their models it's impossible that a patient could know more than they do about our own subjective experience. Which is completely broken beyond simple repairs.

So basically an equivalent in economics would be for people facing worse economic circumstances, say local industry dying or an economic downturn, predicting they would be worse off in the future accurately and interpreting it as saying the equivalent that thinking like a poor person, that accurately predicting worse outcomes, is what makes worse outcomes happen.

There are likely some ideological opinion papers that argue this, but no serious research in economics would be this foolish. The more I think of how medicine works and what few undergrad courses I took in economics and, I mean this seriously: economics is more rigorously scientific than medicine. By a long shot. Medicine has a lower grade of evidence than many social sciences, because of the combination of inability to make truly comparative studies (where everything else actually IS equal) and the hubris that doesn't mind using bad evidence as long as no one cares about the outcomes. Without the hubris it wouldn't be a problem. The hubris is totalitarian.

Medicine has some very reliable and rigorous evidence for many things. It also does silly stuff like this, pure nonsense. It's the presence of all this nonsense that essentially cancels out the rigorous stuff, because in real life it all gets mixed in together like taking the potable water and sewer pipes and merging them. When healthcare meets patients, the rigorous science and BS pseudoscience are on equal footing. This is unique to all the professions.

 

Based on my experience I would actually suggest the patient perception is more likely to be to underestimate the severity. We want to get better. We are told we will get better by doctors and others, including the medical benevolent lie. We usually have no prior experience of chronic illness, in our experience we get better after we get sick. I thought I would get better for many, many years. Had I realized the actual time course I would have selected better strategies.

Its an imperative to ensure there are accurate tests, and I mean biomedical tests, to help predict the course of illnesses like these. We don't have them.

 

My very first blog on ME online was Masks if I recall correctly, and this was a central theme.