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"Comorbid personality disorders in CFS patients: a marker of psychopathological severity" (Calvo)

Discussion in 'Latest ME/CFS Research' started by Dolphin, Apr 16, 2015.

  1. Dolphin

    Dolphin Senior Member

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    Free full text at: http://www.actaspsiquiatria.es/repositorio//17/94/ENG/17-94-ENG-58-65-735302.pdf

     
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  2. wastwater

    wastwater Senior Member

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    uk
  3. Never Give Up

    Never Give Up Collecting improvements, until there's a cure.

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    Hmmm, sadness, irritability, resentment, suspicion, guilt, anxiety, and hostility all seem like healthy, rational responses to all that TOTALLY SUCKS about this disease!

    The next step is to sedate them all so that they will stop expecting anything more from their health care providers.

    Brilliant!
     
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  4. Sean

    Sean Senior Member

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    Gee, I wonder if such an allegedly high rate has anything to do with dodgy definitions?
     
  5. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    Did I miss the ill controls?
     
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  6. Snow Leopard

    Snow Leopard Hibernating

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    This kind of study suffers from severe participation/selection biases. Secondly, those questionnaires are not validated for chronically ill patients and thus their use is highly questionable.

    Only a high quality prospective study (ie one that starts before patients are ill) can really show whether there is a link or not.
     
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  7. Sean

    Sean Senior Member

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    Just more evidence (as if we needed any more convincing) that peer review is badly broken in psychiatry/psychology.
     
  8. Snow Leopard

    Snow Leopard Hibernating

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    The problem isn't peer review, the problem is people who pay no attention to bias when designing a study.
     
  9. SOC

    SOC

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    Most certainly! But any degree of decent peer review should catch poor study design, especially one with obvious bias. You don't even need to be working in the field to recognize study design this poor. If papers at this low level of quality didn't make it past peer review, researchers would start paying attention to reducing bias in their studies.
     
  10. Snow Leopard

    Snow Leopard Hibernating

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    I believe that all studies should be published, no matter how crap. Just that the discussion should be written in a way that is well aware of how crap the study was....
     
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  11. SOC

    SOC

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    We can agree to disagree on that one. :) I have a hard time imagining a researcher being clear in the discussion about what a piece of crap his/her research is. Therefore, I would rather the crap never got into the public record to add confusion and incorrect information into the knowledge pool.
     
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  12. A.B.

    A.B. Senior Member

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    What kind of psychopathology drives people to see psychopathology everywhere?
     
  13. Sean

    Sean Senior Member

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    Beware those in whom the urge to control and punish is strong.
     
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  14. Never Give Up

    Never Give Up Collecting improvements, until there's a cure.

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    I think we need to come up with a name for this! Psychopathology paranoia? Psychopathanoia? Compulsive projection -anoia? Psychopathology fixation? Jerky faced buttheadanoia?
     
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  15. Roy S

    Roy S former DC ME/CFS lobbyist

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    There is a thread on a previous paper on the same general subject here, with a relevant response that @Bob posted.
     
    http://forums.phoenixrising.me/inde...hronic-fatigue-syndrome-a-controlled-s.19947/
     
    ME Research UK
    Breakthrough magazine
    Issue 17
    Spring 2013


    BELGIUM.

    Personality disorders not a factor.

    CDSM-IV axis II personality disorders involve 'maladaptive personality traits', such as obsessive-compulsive disorder. A study from Belgium reports no increase in such personality disorders in ME/CFS patients compared with people in the community (prevalence 16.3% in each group, in contrast with 58.7% in a comparison group of psychiatric patients). No surprise there then, particularly as the results accord with a previous study in 2009 (prevalence 12% in both patients and controls).

    The interesting thing is that both of these 'negative' investigations used the ADP-IV questionnaire to assess personality disorder, whereas other 'positive' studies (reporting moderate differences between ME/CFS patients and controls) have tended to use the PDQ questionnaire which, as the authors point out, gives high rates of false positives and overestimates the prevalence of personality disorder. Such matters are important, particularly when the results of research studies affect the lives of real people, and impact on healthcare professionals' views of the illness!

    Source: Kempke et al., Int J Behav Med, 2012
     
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  16. wdb

    wdb Senior Member

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    If all you have is a hammer, everything looks like a nail
     
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  17. wdb

    wdb Senior Member

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    Trouble is where are you going to find psychologists who will accomplish any degree of decent peer review, most of them wouldn't catch poor study design if it came up and hit them in the face.
     
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  18. alex3619

    alex3619 Senior Member

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    Ill controls with another disease that is not curable, badly understood, and has as much stigma and other issues?
     
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  19. alex3619

    alex3619 Senior Member

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    False positives are a huge problem in this area of research, particularly when they do not distinguish between personality disorder and other circumstances that create a similar view.
     
  20. Sidereal

    Sidereal Senior Member

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    I'm not clear on whether these were 132 consecutive patients diagnosed with CFS by their internal medicine department or was there an unknown greater number of CFS patients seen by the internists from which these 132 were plucked by the authors (psychiatrists) because they were referred to their department for psychiatric assessment. If the latter, no bueno.

    Still, even in a biased sample like this they found

    This is lifetime diagnoses, not current. Quite low for a disorder which most doctors think is just a mood or anxiety disorder.

    Seeing as they had a psychiatrist and a clinical psychologist doing SCID-I for Axis I disorders I don't see why they didn't also administer SCID-II for personality disorders (aside from it taking a really long time to administer so it's easier to just photocopy some questionnaires for the patient to fill out) instead of going with a self-report measure of personality. Clinician-rated measures in psychiatry are not great but they are far less ludicrous than self-reported ones.
     
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