Review: 'Through the Shadowlands’ describes Julie Rehmeyer's ME/CFS Odyssey
I should note at the outset that this review is based on an audio version of the galleys and the epilogue from the finished work. Julie Rehmeyer sent me the final version as a PDF, but for some reason my text to voice software (Kurzweil) had issues with it. I understand that it is...
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BMJ editorial: GET and CBT advised for ME

Discussion in 'General ME/CFS News' started by Countrygirl, May 7, 2015.

  1. Countrygirl

    Countrygirl ME is not MUS

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    Another inaccurate and misleading article appeared in the BMJ today based on the flawed PACE trial.


    Editorial in today's British Medical Journal:

    http://www.bmj.com/content/350/bmj.h2087

    Editorials
     
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  2. Revel

    Revel Senior Member

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    How's this for a "coexisting mood disorder" :devil:!!
     
  3. Some words to them! (put into politer language):
    "Urinate", "go away", "excrement", "craniums"!
    :p
     
    justy likes this.
  4. Dolphin

    Dolphin Senior Member

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    Here's the rest:


     
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  5. Sidereal

    Sidereal Senior Member

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    Odious diatribe.
     
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  6. Marco

    Marco Grrrrrrr!

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    Doesn't strike me as too unreasonable as a summary of the status quo despite the fact that PACE demonstrated nothing.
     
    justy likes this.
  7. Dolphin

    Dolphin Senior Member

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    An uneducated person* could come away from it thinking nothing of significance has ever been found in biomedical research and that CBT and GET have been proven to be very helpful (though the recovery definition used was lax).

    *i.e. with regard to the ME/CFS literature
     
    Last edited: May 7, 2015
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  8. Sidereal

    Sidereal Senior Member

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    No mention of biomedical findings like rituximab and 2-day CPET. All dismissed with a hand wave.
     
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  9. A.B.

    A.B. Senior Member

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    Embarassing for the BMJ.
     
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  10. Jonathan Edwards

    Jonathan Edwards Senior Member

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    Interesting that this was commissioned and not peer reviewed. Which is presumably why the article does not appear to have anything very specific to say. In view of events elsewhere it seems a bit of a damp squib.
     
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  11. Marco

    Marco Grrrrrrr!

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    Frankly there's nothing off about stating that there have been no 'breakthroughs' in terms of finding a replicable and specific physiological abnormality in ME/CFS patients otherwise we wouldn't keep going on about the need to find a 'biomarker'.

    Their suggestion that the primary abnormality lies in the central nervous system is very much in line with current findings and thinking and that the CNS be responding abnormally to normal physiological signals is exactly what researchers like Jared Younger are proposing (leptin levels correlating with fatigue were within normal physiological levels).

    As for pre-existing mood disorders I doubt that there's sufficient evidence to support this but it wouldn't be surprising as 'mood' symptoms often predate obvious physical symptoms in various neurological diseases (which is after all what ME implies?).

    The main issue where I would disagree with them is in their belief that PACE proved effectiveness but their theories aren't unreasonable and they seem to have at least ditched the simplistic notion of deconditioning. Graded exercise (mild as per PACE) as a means to desensitising central (microglial?) overreaction to physiological/metabolic signals is at least a (physical) theory and if we believe (as repeated studies show) that there is autonomic nervous system dysfunction with 'sympathetic dominance' then perhaps theoretically something like CBT may reduce that. If I were to suggest such a scenario and that something like mindfulness meditation might help then I doubt many would bat an eyelid. It would be somewhat hypocritical to deny any potential usefulness for CBT v mindfulness meditation just because of the messenger.

    I could be wrong but I sense some movement here not least in the acknowledgement of the loose definition of 'recovery' and the acceptance that any improvement (in their view) due to GET/CBT was inadequate.

    I'm sure that an 'uneducated' reader (BMJ readers are uneducated?) might think that but quoting small, unreplicated findings isn't going to persuade them otherwise.

    PS - I also find the fact that this was commissioned - 'interesting'.
     
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  12. sarah darwins

    sarah darwins I told you I was ill

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    That article seems to spend almost as much time pointing out how useless the trial was as it does drawing conclusions based on the trial. How does that work?
     
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  13. Dolphin

    Dolphin Senior Member

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    I think many likely are if one is talking about the ME/CFS literature, which is what I had in mind.
     
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  14. Marco

    Marco Grrrrrrr!

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    Can't expect otherwise as many are generalists.
     
  15. Dolphin

    Dolphin Senior Member

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    Coming up with fancy explanations for why CBT and GET might work when in fact they don't appear to work in terms of objective measures (subjective measures may simply represent response biases) doesn't impress or excite me. It's another way to continue prescribing ineffective therapies.
     
    Last edited: May 7, 2015
  16. beaker

    beaker ME/cfs 1986

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    my emphasis

    This joker can't read or is living in a cave. Send him copy of IOM and Lipkin and Montoya studies.
     
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  17. adreno

    adreno PR activist

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    Was there even a mention of the findings of the IOM panel? Or are they just droning on about PACE (Pathetic Attempt at CBT Encouragement).
     
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  18. Marco

    Marco Grrrrrrr!

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    Well I'm neither impressed nor excited and I agree (as I said) that PACE proved nothing but I suspect a subtle crumbling of the deconditioning/false illness beliefs dogma that opens up the debate to physiological/neurological explanations.
     
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  19. jimells

    jimells Senior Member

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    So there's no need to find the cause, treatment, or prevention of the illness. We just need better CBT and more therapists to tell patients that they're thinking the wrong thoughts.

    I guess this is Sir Simon's answer to the Open Medicine Foundation's program of actual research.
     
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  20. Gijs

    Gijs Senior Member

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    This is not science but religion. Loyd and vd Meer are extremists in proclaiming CBT and GET. This stems from the fact that these professors have sought their lives for an explanation for this disease. Their vanity reveals their stupidity on the day there is a real breakthrough. At that point everybody can read there sloppy science and they will revealed as clowns.
     
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