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Fibromyalgia and chronic fatigue syndrome: management issues (Bourke, 2015)

Discussion in 'Latest ME/CFS Research' started by Dolphin, Sep 24, 2015.

  1. Dolphin

    Dolphin Senior Member

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    From: Balon R, Wise TN (eds): Clinical Challenges in the Biopsychosocial Interface. Update on Psychosomatics for the 21st Century
     
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  2. Dolphin

    Dolphin Senior Member

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    Julius Bourke is a psychiatrist who has worked with Peter White on the PACE Trial,
    is working with Peter White on a pain study in CFS
    and
    works in the same place as Peter White.

    He also co-authored this with Peter White:
    Looks like he could be Peter White's protégé.

    Also, I just searched and:
    "He pursued higher training at The Maudsley and King's College Hospitals" (home of Simon Wessely)
    and he co-wrote two publications with Simon Wessely (one on Gulf War illness).
     
    Last edited: Sep 24, 2015
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  3. Dolphin

    Dolphin Senior Member

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    I don't know the Fibromyalgia literature that well so am not in a good position to critique that section of the report. It is mainly about treatments so it's unclear whether it is significant that peripheral findings are not mentioned (e.g. small fibre neuropathy). This author is big into central sensitisation so may have a bias against such findings.
     
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  4. Dolphin

    Dolphin Senior Member

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  5. Dolphin

    Dolphin Senior Member

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    The definition of recovery in ref. 70 was rubbish (very lax).
     
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  6. Dolphin

    Dolphin Senior Member

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    Reference 78 is an "empiric" criteria (Reeves et al., 2005) study i.e. most probably didn't have CFS.
     
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  7. Dolphin

    Dolphin Senior Member

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    MDD = Major Depressive Disorder.

    Ref. 90 is an empiric criteria study (Reeves et al., 2005).

    Jason et al. found that 38% of the patients who had MDD satisfied the criteria for CFS

    Lots of people quote these empiric criteria studies: not just something Julius Bourke does. And it's not always clear the empiric criteria were used to those that don't know where to look.
     
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  8. Dolphin

    Dolphin Senior Member

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    So he thinks the cognitions and behaviours White, Shape and others claim perpetuate CFS do perpetuate the condition.
     
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  9. Dolphin

    Dolphin Senior Member

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    What's going on!? A CBT school of thought psychiatrist is criticising a study done by other CBT school psychiatrists (Cleare et al.)? Oh, it's criticising a study that found a non-psychiatric drug might be useful ...
     
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  10. Dolphin

    Dolphin Senior Member

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    The author doesn't give a reason for the last sentence.
     
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  11. Dolphin

    Dolphin Senior Member

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    So he doesn't tell the readers the real results of this trial that cost around £1.4 million of UK taxpayers' money:
     
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  12. Dolphin

    Dolphin Senior Member

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    Simon summarised the results in this table:
    cbtget4pain.jpg
    (from: http://phoenixrising.me/archives/18648 )
     
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  13. Dolphin

    Dolphin Senior Member

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    (Discussing the PACE Trial)
    Only positive results are subsequently discussed regarding the PACE Trial. Readers might thus believe that there were improvements with employment.
     
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  14. Dolphin

    Dolphin Senior Member

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    The recovery criteria in the PACE Trial, as mentioned above, were very lax and rubbish.

    None of the factors in the last sentence mention that the therapy could be the problem: instead the problem of a poor response is all put on the patient.
     
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  15. Dolphin

    Dolphin Senior Member

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    I don't believe "remission should always be a goal" with CBT and GET: it's not realistic.
     
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  16. Denise

    Denise Senior Member

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    @Dolphin thank you for breaking this down and for critiquing it.
    Much appreciated!
     
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  17. SOC

    SOC Senior Member

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    This is another name that needs to go on our list of "researchers" to give to the media when the details of the physiology of ME are known. The media will love the horror stories of people who treated sick people so dreadfully in order to serve their own egos and pockets.... as long as we don't let it all get swept under the rug.
     
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  18. barbc56

    barbc56 Senior Member

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    I'm exhausted just from liking all of these posts by @Dolphin. I'm sure I missed some.

    Too bad we don't have a like button for an entire thread. However, there are probably very few threads that would fit into this category.

    Thanks again!

    Barb
     
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  19. Effi

    Effi Senior Member

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    Europe
    just FIY these guys:
    are also very heavily BPS/psychosomatic. It's funny how they keep using each other's studies to prove what they already 'know'. And it's still called science...
     
    Last edited: Sep 25, 2015
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  20. A.B.

    A.B. Senior Member

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    Another confused Wessely school believer that doesn't live in reality. Let's try to translate these weasel words:

    Translation: the diagnoses were controversial in the past, but are no longer controversial. Patient's lack of faith in treatment isn't because the therapy is ineffective but because there is debate about whether this is a physical or mental illness. The therapy is really effective but the debate prevents patients from getting well.

    Translation: we have it all figured out.

    Translation: the PACE trial is robust scientific evidence.
     
    Last edited: Sep 25, 2015
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