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"Functional limitations in functional somatic syndromes and well-defined medical diseases" Joustra

Discussion in 'Latest ME/CFS Research' started by Dolphin, Aug 1, 2015.

  1. Dolphin

    Dolphin Senior Member

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  2. Dolphin

    Dolphin Senior Member

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  3. Dolphin

    Dolphin Senior Member

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    There was no psychobabble (I recall) in this paper, which is unusual given it uses the term "functional somatic syndromes".

    Also, no mention of CBT, GET or similar.
     
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  4. Esther12

    Esther12 Senior Member

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    I have to admit that from the abstract (and the journal it was published in) I thought it would probably be an excuse for 'need more money for BPS rehabilitation' stuff.
     
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  5. Dolphin

    Dolphin Senior Member

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    MCS=Mental Composite Score

    Here's an example where one would often get psychological speculation, attributions, etc. but instead they give a sympathetic interpretation.
    Another reason that the MCS scores can be lowered in CFS cohorts (and probably FMS also) (that the authors may not be aware of) is that the MCS is partly made up of scores from energy/vitality and social functioning (see, for example, this paper "Comparison of UK and US methods for weighting and scoring the SF-36 summary measures" free at: http://jpubhealth.oxfordjournals.org/content/21/4/372.long).

    These scores can be lowered in CFS independent of any mental health issues.
     
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  6. Dolphin

    Dolphin Senior Member

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    If you had more than one FSS e.g. CFS and FMS, you were excluded: only those with one FSS were included. Given previous research has found that those having CFS and FMS are more ill/disabled on average than those with CFS alone, this would have the effect of underestimating the level of disability found in CFS (or FMS and IBS).
     
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  7. Dolphin

    Dolphin Senior Member

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    This could have the effect of meaning the sample was less disabled than a complete sample of those with CFS (and FMS, IBS, etc.)
     
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  8. Dolphin

    Dolphin Senior Member

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    A higher percentage of CFS patients were working than one would often see:

    Controls:

    Working %
    All: 67.8%
    Men: 73.8%
    Women: 63.1%

    Hours worked:
    All: 33.6
    Men: 40.5
    Women: 27.2

    CFS
    All: 50.3%
    Men: 59.6%
    Women: 44.1%

    Hours worked:
    All: 33.5
    Men: 40.6
    Women: 27.1

    Also the hours worked was high.

    Sick leave wasn't huge (days/3 months)
    Controls: 0.8
    CFS: 1.5

    Frequent sick leave (%):
    Controls: 3.6%
    CFS: 13.7%

    CFS was self-reported. I have concerns that when one asks people if they have "chronic fatigue syndrome" one can get people who have chronic fatigue (I have similar concerns about the Canadian studies that quote high prevalence rates for CFS).
     
    Last edited: Aug 1, 2015
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  9. Dolphin

    Dolphin Senior Member

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    Note that controls weren't all healthy:

    Table 1 has a table of frequent medical conditions that were found in the controls.
     
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  10. Dolphin

    Dolphin Senior Member

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    Early retirement and work disability among the working age population:

    Early retirement due to health-related reasons (%)
    Controls: 2.0
    CFS: 15.4
    MS: 20.5

    Disability % Mean
    Controls: 53.5
    CFS: 75.8
    MS: 80.1

     
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  11. Dolphin

    Dolphin Senior Member

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    A limitation:
     
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  12. Dolphin

    Dolphin Senior Member

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    Concluding paragraph:

     
  13. A.B.

    A.B. Senior Member

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    The fallacy of psychological inference: no physical cause for these symptoms is known, therefore no physical cause exists, and therefore the cause must be psychological.
     
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  14. Dolphin

    Dolphin Senior Member

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    I don't want to confuse anyone but the first two parts of these sentences are incorrect (I'll put in a strike-through line to try to stop people getting confused).
     
  15. Dolphin

    Dolphin Senior Member

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    The end of that sentence is rather stark. There is a chance that was an unfortunate short hand and what they meant was "known organic pathology."

    Here's the start for what it's worth:

     
  16. Dolphin

    Dolphin Senior Member

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  17. Dolphin

    Dolphin Senior Member

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  18. Sean

    Sean Senior Member

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    Yes, just one little word makes all the difference.
     
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  19. Valentijn

    Valentijn Senior Member

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    By Dutch standards, those hours are too high. The average here is about 29 hours per week. Mothers of young children very rarely work at all (childcare is too expensive, plus tradition), and mothers of older children will generally be volunteering or working only part time.

    It's also pretty easy for people to work part time when needed. So it doesn't make much sense that the supposedly sick CFS men are all still working full time, if they're working at all.

    The Netherlands has the additional problem that CFS is often explicitly equated with burnout. Burnout is generally described as being a temporary adrenal and/or mood dysfunction triggered by a stressful job.
     
    Last edited: Aug 2, 2015
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