The 12th Invest in ME Conference, Part 1
OverTheHills presents the first article in a series of three about the recent 12th Invest In ME international Conference (IIMEC12) in London.
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CBT ineffective for somatoform disorders and medically unexplained physical symptoms (MUPS)

Discussion in 'Other Health News and Research' started by Sidereal, Nov 4, 2014.

  1. Sidereal

    Sidereal Senior Member

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    A Cochrane systematic review & meta-analysis published a few days ago shows abysmal effect sizes for CBT compared to standard care in the treatment of "somatoform disorders".

    http://www.ncbi.nlm.nih.gov/pubmed/25362239

    Their objective was:

    You can bet many of these folks had CFS, FM, POTS etc., although they do say that they excluded people who had "only one specific functional syndrome":

    Here's the list of quackish interventions studied:

    They forgot to include blood letting and mercury salts.

    Outcome measures were of course various self-report somatisation scales/questionnaires. Even so, the effect size was small and there were substantial methodological problems with the included studies:

    The already poor effect was further reduced at one-year follow-up:

    CBT had essentially no effect on functional disability and quality of life (mostly measured by the SF-36):

    The only analysis approaching an objective outcome was healthcare use:

    In other words, while the patients were being brainwashed by CBT, the number of doctor visits and medication use declined. CBT in the case of treatment of MUPS always involves convincing the patient to let go of searching for a medical explanation for their symptoms and to embrace a psychological aetiology. Sometimes the patients are explicitly told that they can only participate in therapy if they agree not to pursue medical investigations at the same time. This would explain the initial difference. However, at one-year follow-up, when the patient has had the chance to see how ineffective the psychological approach has been, the difference in doctor visits and medication use is zero between the CBT group and the control group.

    Naturally, the review does not contain a whiff of objective outcomes like employment or receipt of disability benefits.
     
    Last edited: Nov 4, 2014
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  2. Sean

    Sean Senior Member

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    Surprise!
     
  3. A.B.

    A.B. Senior Member

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    Even when the patients want it, it doesn't work.
     
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  4. Summary:
    "Mumbly-wank by psych smegheads achieves bugger all change in people who are terribly ill and thus wasted their time and shortening lives on this bovine excrement!
    CBT we must therefore assume is Complete Bloody Twaddle!"


    Oh my, there's a sodding surprise, not! :p
     
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  5. chipmunk1

    chipmunk1 Senior Member

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    we already knew that b*haviourism doesn't work that well for somatoform disorders. Fr*udianism (Psychodynamics) doesn't work either. It does work for keeping the patients away from doctors. maybe that's what they want to achieve?

    CBT in the case of treatment of MUPS always involves convincing the patient to let go of searching for a medical explanation for their symptoms and to embrace a psychological aetiology

    Embracing a psychological aetiology, means accepting that it is my fault that i feel sick and that i should feel guilty for bothering others with my personal problems.
     
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  6. JAM

    JAM Jill

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    In that context. Who ever decided to promote this as a cure to any physical disease must have been possessed by evil incarnate. But as intended (as a way to cope with harmful emotional stimuli) it is effective. I really hope we can not throw the baby out with the bathwater. It is very helpful when used properly.
     
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  7. adreno

    adreno PR activist

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    I don't see why this would be the case, anymore than it is for physiological etiologies.
     
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  8. Sidereal

    Sidereal Senior Member

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    Right. The purpose of these "therapies" is to reduce healthcare spending. They provide justification for refusing people referrals to specialists, tests, treatments. After all, as SW said, "unnecessary investigations" may lead to "hypothesis generation" about what else may be wrong with the patient, other than their defective personality.
     
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  9. chipmunk1

    chipmunk1 Senior Member

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    for somatoform disorders it is very often the case.

    diabetes, cancer:

    poor sick person you deserve all available medical treatments.

    fibro, cfs:

    you need to learn....
    it is not good if we let you access medical treatment xy...
    we count your visits to healthcare providers. almost always you frequent them too much...
    you should see us less...
    You are not aware that you ...
    you have the following character flaws...
    you could improve this...
    we don't like cases like you...
     
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  10. The psychs are "Evil Incarnate"
    Modern day Cult of The Invisible Sky God pretending to be Science wrapped up in very twisted egotistical personalities with very little empathy or compassion, using their power to single out, belittle, abuse and destroy people, not with bonfires and branding irons or beheading, no, but destroying them as people. people who are so sick they cannot fight back.
    Typical attitude of cowardly little bullies.

    Too many psychs seem to be sociopaths or bordering on such behaviour, ala The Milgram Experiment.
    Gives them full fledged excuse, only in their heads, to do ANYTHING.
    Up to and including dragging children form their families, torturing children, and causing such extreme torture by exacerbation of medical conditions and misuse of potent drugs that patients die in one of the most horrific ways there is to be murdered, or they have taken part in a deliberate policy of dehumanization for social exclusion and inevitable thousands of deaths that causes and IS causing.
     
  11. JAM

    JAM Jill

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    Wow. I that doesn't describe any of the professionals I have worked with. When used properly I have gained great benefit from working with them. You seem to have quite a large chip on your shoulder.
     
  12. Valentijn

    Valentijn The Diabolic Logic

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    There's a distinct classification and special contempt for patients accused of having physical symptoms caused only by psychological factors. The vast majority of medical professionals sensibly wouldn't expect someone to think their way out of major depressive disorder or schizophrenia, yet it's demanded that we do it, and we are blamed when we don't.
     
  13. chipmunk1

    chipmunk1 Senior Member

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    [satire]well if you manage find a gentle and emphatic ECT practitioner things are probably not that bad. ;)
     
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  14. adreno

    adreno PR activist

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    You have a seriously twisted view of reality.
     
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  15. JAM

    JAM Jill

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    ECT? I'm not saying that they are all perfect, just that they are not all evil incarnate. I worked closely with several CBT practitioners while getting my graduate certificate in Disability Policy and Practice, granted a special segment of the profession is drawn to that kind of work, so may not be the norm, but to suggest that all practitioners in the field are evil is ridiculous. We need to speak out against those that are, but will not be taken seriously if we try to paint a whole profession with the same brush.
     
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  16. Cheshire

    Cheshire Senior Member

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    Psychs are evil. Wowww, what an overgeneralization.

    I don't think the problem is with psychs per se.

    The problem is with health care practitioners that support the view that physical symptoms without explanation MUST be the consequences of psychiatric disturbances.


    In my own journey, psychiatrists and psychologists have been very helpful because they all acknowledged that I don't have any psychiatric issue and that I have a medical problem that medicine don't understand. On the other hand, all the meds I met but my actual GP, all said I have a psychiatric disorder, despite the psychiatric assessments I underwent...


    There certainly are pervert psychiatrists (IMO P White is a good candidate), because all professions in which one takes care of others are attractive to such people (teachers, priests are good example of jobs attracting paedophiles), and they can be very very dangerous. But that doens't mean they all are!!

    We are struggling against the clichés used by Whyte and co. We shouldn't use them, and look for acuracy and truth.
     
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  17. alex3619

    alex3619 Senior Member

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    Anecdotally this was suggested by a psychiatrist to one of our members - ECT is the next step when CBT does not work.
     
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  18. ahmo

    ahmo Senior Member

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    Received this post yesterday.


     
    Last edited: Nov 4, 2014
  19. Cheshire

    Cheshire Senior Member

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    cchr is the church of scientology... No more scientific than Chalder or Crawley's prose :eek:
     
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  20. ahmo

    ahmo Senior Member

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    Thx Cheshire. Haven't watched the vid, didn't know the organization.
     
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