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Deary project: Improving Patient Pathways for Persistent Physical Symptoms

Discussion in 'Other Health News and Research' started by Esther12, Dec 14, 2016.

  1. Esther12

    Esther12 Senior Member

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    I've not seen any discussion of this here, but I was just looking through and it looked pretty odious.

    When I was reading it I kept hearing Deary's voice saying the words... this was not a pleasant experience so I stopped! Thought I might share the joy though!

    http://www.ahsn-nenc.org.uk/project/226/
     
  2. hixxy

    hixxy Senior Member

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    I dunno, but don't all uncured diseases have persistent symptoms?
     
  3. Esther12

    Esther12 Senior Member

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    They do get themselves in a bit of trouble here...

    new.ahsn-nenc.org.uk/wp-content/uploads/sites/3/2014/12/ImpPatientPath-Case-Study-30-AUG-2016-FINAL.pdf

    Symptoms are pretty difficult to fully explain via pathology. I'd have thought that loads of conditions (MS, Lupus, etc) have symptoms that cannot be fully explained by our current understanding of their pathology. But Deary means, you know, those troublesome patients... you know the sort... 'not fully explained by pathology' is the empowering and collaborative way of describing it.
     
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  4. hixxy

    hixxy Senior Member

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    I think there are very few diseases where all symptoms are fully explained by pathology.
     
  5. Woolie

    Woolie Senior Member

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    I'm blown away by the sheer proliferation of names in this area. We had "medically unexplained symptoms", "somatic symtpoms disorder", "bodily distress syndrome" and now "persistent physical symptoms". The idea seems to be to keep it moving all the time, so people won't notice that you're just saying the same old thing (its psychological) and just changing the names.

    The clues are in the "resource sheet":
    Actually, some of the material in the resource sheet is kind of good - you know, saying the symptoms are real. And many patients may feel enormous relief to be told this, even by a leaflet. But its still unsettling. Kind of like that nice friendly chat you had once with that evangelist... until you realised he was just laying the ground work so he could hit you with the really heavy doctrine.
     
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  6. Woolie

    Woolie Senior Member

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    The BPS response to that is simple - all diseases have a "psychological" component. The symptoms that aren't fully explained, those are the psychological ones.
     
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  7. Woolie

    Woolie Senior Member

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    Reading on... I see the horror of it all but for some reason I just can't look away...

    The whole project is sold on the basis that people with "PPS" simply cost doctors too much time and resources, and we need to sort that out, get them out of our surgeries so we can deal with the really sick people:
    Oh, and there you have it, the elephant in the room:
     
    Last edited: Dec 15, 2016
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  8. sarah darwins

    sarah darwins I told you I was ill

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    Bingo. Only this crowd can state that a condition has symptoms that aren't understood in one breath, then outline a program in which they explain those symptoms to the sufferer in the next. Impossible is nothing for Team Psychosocial.
     
  9. Sean

    Sean Senior Member

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    I am old enough to remember when that was called lying, and worse.

    And what a nasty little dog whistle about the economic burden of such 'syndromes'. A particularly callous act of cowardice.
     
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  10. Woolie

    Woolie Senior Member

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    Actually, thinking about it further, a lot of the name changes might be designed to increase the scope of the diagnosis, so that more and more patients will be able to meet it. In this project, they manage to claim that PPS applies to 20% of all patients!

    This is part of the pitch too: "Look at the size of the problem, I bet you never knew just how big it was - and we're the ones to solve it for you!"
     
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  11. Cheshire

    Cheshire Senior Member

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    The desire that one's name will be set in stone can be a factor too.

    Every team working in this field tries to promote its term, Fink and al., Bodily distress syndrome, Deary seems very proud of his "Persistant Physical Symptoms", I remember Chalder saying she prefered something like Medically Unexplained Persistant Physical Symptoms, Stone favors the word functional and so on...
     
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  12. Woolie

    Woolie Senior Member

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    Its great eh - you can't rename MS or RA, how dull. But you can be so creative in this field, because anything goes!
     
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  13. A.B.

    A.B. Senior Member

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    It defies logic to conclude that the unexplained is explained because it is unexplained.
     
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  14. Jo Best

    Jo Best Senior Member

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    I think they opted for PPS over MUS/MUPS as it's 'more positive'!

    ETA - just saw this thread on the subject from 2014 - http://forums.phoenixrising.me/inde...tional-symptoms-postive-practice-guide.31581/
     

    Attached Files:

    Last edited: Dec 15, 2016
  15. Gijs

    Gijs Senior Member

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  16. alex3619

    alex3619 Senior Member

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    This is a fallacy they commit here. Its defined, and published, and I blogged on it. I would like to say if something is unexplained, its unexplained. You can either say "I don't know" or you can say "we need to investigate further" but you can't say, without being irrational, "it must be psychological".

    There is also a formal psychogenic fallacy that is a bit different, to do with arguments, and not relevant here.

    One of the defenses they try to use, in defending psychogenic/psychosomatic diagnoses, is that only 4% are ever rediagnosed. This is another crock. What they should have said is there is a study that shows this, the patients are only followed for a year (it can take decades for a proper diagnosis, and many decades if the test is not developed or available) and are in hospitals that don't run tests on psychogenic patients. After all, its expensive and there is nothing to find. Its a crock, as I already said. Complete BS.

    The earliest defined disease I can find that they claimed this kind of thing for was Tuberculosis, and there are now probably hundreds of diseases, including every kind of cancer, for which this was claimed. Its a total failure in historical terms, but convenient to deny patient care.
     
  17. Valentijn

    Valentijn Senior Member

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    And even more importantly (for the quacks) - CBT is consequently necessary for all patients with any biomedical disease :rolleyes:
     
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  18. alex3619

    alex3619 Senior Member

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    Another thing that really annoys me is that there are lots of people who genuinely need psychiatric help, yet this fiction will take resources away from those people. Sooner or later some government agency will keep records, and actually look at them, that show this is a colossal failure, and then psychiatry is likely to find itself with even less funding - this is a disaster for psychiatry, not just supposed and real psychiatric patients.
     
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  19. Luther Blissett

    Luther Blissett Senior Member

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    For a wider social context and use for these types of 'Treatments', these graphs I came across, I found interesting.

    gp vacancy rate.png

    doctor recruitment.jpg

    So, these treatments are being pushed at the same time as there is a growing need for an answer to what could become a bit of a political/social problem.
     
  20. Esther12

    Esther12 Senior Member

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    It does all seem so manipulative. A salesman saying what a lovely family you have is only going to make suckers feel good.
     
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