Trial By Error: New Biopsychosocial Study of Fatigue in HIV Patients

Andy

Andy

Retired committee member
And here’s yet another study from Professor Trudie Chalder and colleagues at King’s College London, this time tackling fatigue in people with HIV—an often debilitating problem. The study—“A Biopsychosocial Approach to HIV Fatigue: A Cross-Sectional and Prospective Analysis to Identify Key Modifiable Factors”—was published online last month by the journal Behavioral Medicine.

The causes of HIV-associated fatigue are multifactorial and not fully understood, so it would be great to find effective ways to address it. (Many of the HIV-positive gay men I know in my age cohort—I’m 63—are dealing with some variant of this.) Some common psychological correlates of HIV infection, such as depression and feelings of social isolation, could contribute to fatigue. Like others experiencing complex health issues, many HIV patients could possibly benefit from receiving psychotherapy along with appropriate medical treatment. By helping people adapt their lives to current circumstances and lower their stress levels, such interventions could lead to improvements in fatigue and other indicators.

So this HIV study should potentially be good news. Unfortunately, it features one of the scientific missteps that have marred other work from biopsychosocial experts: the assumption that a reported association is evidence of a specific causal relationship. First-year epidemiology students are warned not to confuse association with cause, yet these experienced researchers seem not to have learned that fundamental lesson. Moreover, the new study will seem familiar to readers of previous articles from this body of research. No matter what disease is being examined —chronic fatigue syndrome/myalgic encephalomyelitis (as these researchers often call the illness in question), irritable bowel syndrome, HIV—the argument seems much the same.
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http://www.virology.ws/2020/03/02/t...sychosocial-study-of-fatigue-in-hiv-patients/
 
Funding
AH and TC are part funded by the National Institute for Health Research (NIHR) Biomedical Research Center at South London and Maudsley NHS Foundation Trust and King’s College London, England. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
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I don't know the history of this thing, but why are these groups funding her group?

@dave30th Have you invited her to respond to your criticisms? Can you petition the journal to release the peer-review comments? EIC seems to be a bit of a self promoter (you google).....


Editorial board
Editor in Chief:

Perry N. Halkitis, PhD, MS, MPH, School of Public Health, Rutgers University, Newark & New Brunswick, NJ perrynhalkitis@gmail.com
Subject Areas: LGBTQ Health; Men’s Health; Biopsychosocial Aspects of HIV/AIDS, HPV & Other Sexually Transmitted Infections; Drug Use and Abuse; Methamphetamine; Mental Health; Urban Public Health; Resilience; Health and Human Development; Psychometrics; Applied Statistics; Biostatistics

Managing Editor:

Kristen D. Krause, MPH,School of Public Health, Rutgers University, Newark & New Brunswick, NJ, kristen.krause@rutgers.edu
Subject Areas: Resilience; Aging; HIV/AIDS; LGBTQ Health


Student Editor:

Caleb LoSchiavo, MPH, School of Public Health, Rutgers University, Newark & New Brunswick, NJ, cel129@sph.rutgers.edu
Subject Areas : Sexual and Gender Minorities; Transgender Health; HIV/AIDS; Substance Use; Sexual Health
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ScottTriGuy said:
I told my HIV+ friend about the research -- he said, dripping with sarcasm, "Oh, so that's why my fatigue disappeared when I switched one of my HIV meds. It corrected my dysfunctional thinking."
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But if fatigue is a medication side effect that would mean physicians might feel bad about themselves and the drug industry might risk lawsuits. It's so much better to just agree that the patients are to blame for fatigue.
 
I'm still waiting for them to expand into the automotive business... we've discovered that the people with most unreliable cars are the ones that spend the most time worrying about them, we propose that treating this symptom focusing will make the cars work better.
 
NelliePledge said:
At some point they will stick their fingers in a pie too far - could HIV be the one? Let’s hope so.
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It all depends how slowly the frogs are boiling, especially in non contentious diseases like AIDS or MS.

My feeling is the PR job on convincing the whole world that they are a bit mentally ill is miles ahead of the almost invisible resistance that the definition of mental illness is now almost meaningless.

People almost seem to lap it up and egg it on. The other problem is that huge numbers of people don't understand that neurological and psychological are not the same thing
and many more will take the, "interface of psychiatry and neurology", notion at face value completely unquestioningly and in general for everything medical.

Then there's the stress can cause....... (fill in the numerous disease categories).

Behaviorialists are everywhere in media and on TV and people absolutely buy into them and hang on every word they say.

Most people now have zero ability to critically reason and if you asked them to source or cite a claim they made they look at you as if you are nuts and/or rude.

Most peoples response to, "how do you know that what is the evidence for it," is "it was on the news".

Everyone is entitled to an opinion has now become zero evidence is required to make a claim and its those who bring evidence to an argument that are the pariahs.
 
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ScottTriGuy said:
"Oh, so that's why my fatigue disappeared when I switched one of my HIV meds. It corrected my dysfunctional thinking."
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BPS types may well claim that his fatigue must have been due to a nocebo expectation response to the previous medication! Switching to a new medication without any negative mental associations allowed his mind to lift the fatigue!

large donner said:
My feeling is the PR job on convincing the whole world that they are a bit mentally ill is miles ahead of the almost invisible resistance that the definition of mental illness is now almost meaningless.
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The amount of people in my and adjacent age groups who think that everybody should get 'therapy' is rather appalling. It's its own sort of 'woke' groupthink phenomenon.
 
I was watching a repeat of Simon Reeves in Russia (on the BBC) and he visited a place called Tuva where the inhabitants go to a local shaman who, although in full traditional costume, is set up in an office with a waiting room etc much like a GP. He was 'curing' a man of alcoholism.

I'm sure most viewers would have found it ridiculous....and yet(?)
hmm makes you think.
 
James Morris-Lent said:
The amount of people in my and adjacent age groups who think that everybody should get 'therapy' is rather appalling. It's its own sort of 'woke' groupthink phenomenon.
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There’s a lot to be said for having someone who isn’t a friend or relative, boss or colleague to talk to about stuff that you’re finding hard, grief for example - all those people have their own agendas. I have been talking to a counsellor regularly every 4-8 weeks for over 10 years. My mental health is a lot more normal than my physical health I see it as a preventative measure.
 
chrisb said:
Probably even injuries sustained from a blow with "a heavy, blunt instrument" must be considered interpretable as biopsychosocial.
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Of course, they are the essence of biopsychosocial!
They would naturally focus on the psychopathology of the person administering the blow to the head and the thought patterns and beliefs of the injured person that lead him or her to socially engage with this person....

The head injury itself probably gets aggravated by excessive worrying and symptom focusing, and should you need surgery you'd better believe you're going to make it, or the outcome might not be that favorable.
;):wtf::confused:
 
Anna H said:
Of course, they are the essence of biopsychosocial!
They would naturally focus on the psychopathology of the person administering the blow to the head and the thought patterns and beliefs of the injured person that lead him or her to socially engage with this person....

The head injury itself probably gets aggravated by excessive worrying and symptom focusing, and should you need surgery you'd better believe you're going to make it, or the outcome might not be that favorable.
;):wtf::confused:
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this is funny and enraging at the same time, because it's so true! I've been hearing "the medication doesn't work on you because yo don't believe it will" for 22 years! I always respond, "well, I don't believe cyanide will work, does it mean taking it won't kill me?"
 
glennthefrog said:
"the medication doesn't work on you because yo don't believe it will" for 22 years!
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This argument always amuses me.

Confession - until I got ME (or yuppie flu as the papers informed me) I didn't really believe in it. I wasn't a b***** about it, I didn't really think about it at all. I just knew what the papers printed.

Turns out I don't have to believe in it to have my life turned inside out and upside down and watch 22 years of fulltime education, plus 10 or so years of building a career go down the pan....
 
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