A New Decade of ME Research: The 11th Invest in ME International ME Conference 2016
Mark Berry presents the first in a series of articles on the 11th Invest in ME International ME Conference in London ...
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Comments by Prof Norman Booth on one of Prof Crawley's 2016 papers

Discussion in 'General ME/CFS News' started by Countrygirl, Feb 21, 2017.

  1. Countrygirl

    Countrygirl Senior Member

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  2. halcyon

    halcyon Senior Member

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    EC is drunk on the kool-aid.
     
  3. aaron_c

    aaron_c Senior Member

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    How does peer review actually work, then? Crawley's paper was reviewed--poorly--but then he still publishes it as a peer-reviewed paper, right? And without any reference to the fact that at least one of the peer reviews was quite negative?
     
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  4. Barry53

    Barry53 Senior Member

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    That is a very valid observation. Claiming your work has been peer reviewed is meaningless if the reviewee is at liberty to ignore reviewers' comments as they see fit? Is there no proper oversight and enforcement to this process? Or is it just a lip-service exercise, so the various fob-them-off boxes can be ticked.
     
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  5. Large Donner

    Large Donner Senior Member

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    It doesn't.
     
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  6. Valentijn

    Valentijn Senior Member

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    Ah, so she does read Wiborg's work. In which case she surely read his paper from 2010 where it was conceded that CBT/GET does fuck-all to improve physical functioning as measured by actometer.
     
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  7. Hip

    Hip Senior Member

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    I don't see that much wrong with this paper by Esther Crawley et al, and welcome more research on comorbid depression in ME/CFS. I am one of the ~30% of patients that unfortunately does suffer from comorbid depression, and I can tell you it is a bugger to treat. I have trying for years to find some effective treatments. A poll on this forum found that 37% of ME/CFS patients are depressed.

    Like my ME/CFS itself, I am pretty sure my depression is not psychogenic; it does not result from my more limited life circumstances under ME/CFS; my depression is definitely neurologically caused.


    Normally those with depression have recourse to exercise, which is known to raise mood, likely via an endorphin mechanism. But in ME/CFS you don't have recourse to exercise, for two reasons:

    Firstly because many ME/CFS patients will get PEM after exercise, so exercise is pretty much out of the question in these cases.

    Secondly, even for patients like myself that do not get much PEM from physical exercise, it is well known that in ME/CFS you lose the normal mood boosting antidepressant of exercise. So even if you can do exercise, it does not really help your depression.

    I can definitely confirm this: before developing ME/CFS, I always found a strong mood boosting effect from exercise, even from just a 15 minute jog, and I loved doing exercise for this very reason. But now with ME/CFS, it does not matter what type of exercise I do (running, brisk walking, going to the gym and doing weights), there is very little improvement in mood.

    I think the comorbid depression in ME/CFS may be a particular form of depression that is hard to treat. It may be linked to some dysfunction in the endorphin system (a couple of studies have found endorphins low in ME/CFS: refs: 1 2).

    It is interesting that in Crawley et al's review, they state that one study found "significant improvements in CFS/ME and depressive symptomatology in response to S-citalopram", as well as improvements in PEM, headaches, un-refreshing sleep and impaired memory and concentration from this drug. S-citalopram is otherwise known as escitalopram (Lexapro), which is an antidepressant and anti-anxiety drug I have not yet tried. I'll have to try escitalopram (although I am wary of SSRIs, given that when I tried citalopram, it massively increased my depression levels).

    It is interesting that escitalopram has been found to reduce pain levels in patients taking opioid pain medications. That perhaps suggests that escitalopram might work on the opioid and endorphin system.


    Also of note is that this review mentions antiviral treatment of ME/CFS using valacyclovir was observed to reduce depression symptoms (but treatment regimens were 3 to 60 months long).


    I have to agree with Prof Norman Booth's criticism that the issue of comorbid depression needs to be tackled in terms of understanding the underlying biology and pathophysiology. I think psychologists would do well to team up with neurologists, immunologists and biochemists when studying the neuropsychological symptoms or neuropsychological comorbidities of ME/CFS.
     
    Last edited: Feb 22, 2017
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