Illness experience, depression, and anxiety in chronic fatigue syndrome (2002)

[Dolphin]

Free full text: http://individual.utoronto.ca/mandel/jpr2002.pdf

Somebody recently drew my attention to the following study. I'm not as much with a lot of the older papers (7+ years old) so wasn't aware of it.

Illness experience, depression, and anxiety in chronic fatigue syndrome.

J Psychosom Res. 2002 Jun;52(6):461-5.

Lehman AM, Lehman DR, Hemphill KJ, Mandel DR, Cooper LM.


Source

Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada


Abstract

OBJECTIVE:

Given the high rate of psychiatric comorbidity with chronic fatigue syndrome (CFS), we considered two possible correlates of anxiety and depression: lack of illness legitimization and beliefs about limiting physical activity.

METHOD:

A total of 105 people diagnosed with CFS reported on their experiences with medical professionals and their beliefs about recovery and completed the depression and anxiety subscales of the Brief Symptom Inventory.

RESULTS:

Those who said that their physician did not legitimize their illness (36%) had higher depression and anxiety scores (P's<.05) than their counterparts. Those who believed that limiting their physical exertion was the path to recovery (55%) had lower depression and anxiety scores (P's<.01) than their counterparts.

CONCLUSION:

Lack of illness legitimization ranked high as a source of dissatisfaction for CFS patients, and it may aggravate psychiatric morbidity. Many CFS patients believed that staying within what they felt to be their physical limits would improve their condition. This belief, and possibly an accompanying sense of control over their symptoms, may alleviate psychiatric morbidity.


PMID: 12069870 [PubMed - indexed for MEDLINE]

 

[Dolphin]

The finding is based on a question:

There is little agreement among medical professionals regarding how
people recover from CFS or whether or not they show improvement.
Nevertheless, some people with CFS have one or more hunches or
theories. Do you have any hunches or theories about how your own
improvement or recovery can be facilitated? If yes, what are they?
(beliefs about recovery question)

The results were put under different headings by the authors - see Table 5:

Frequencies of responses to the question of how recovery or improvement
could be facilitated

Fifty-five percent said that adhering to personal physical limitations was the key to their rehabilitation. Those coded for such a response had significantly lower depression and anxiety scores than those providing other responses (Table 4). Sample responses included: Pace myself, rest, approach it cautiously to ensure I dont get tired and Controlling impulses to do cognitive and physical work when not up to it. Controlling myself from doing things that will make days or weeks of illness.

 

[Esther12]

Thanks.

I think I remember you (or maybe someone else) posting another paper here that showed that housebound CFS patients suffered from lower levels of emotional distress than those who were more active. Pushing oneself to the limit all the time is emotionally draining... but not doing much is emotionally difficult too. I can't believe behavioural type research has so dominated CFS research funding, and yet we still have such a poor idea as to the optimal way of behaving.

 

[max]

esther12... "I can't believe behavioural type research has so dominated CFS research funding, and yet we still have such a poor idea as to the optimal way of behaving."

simply because "behavioural type research" is fraud when presented as scientific evidence. Behavioural research is based on subjective opinion, not reproducible under identical conditions as is the case with science.

We will not win until psychiatry is exposed as fake when applied to the individual. We are all normal human beings - behaviour is not an illness, it is an individuals response to the world they live in - however far an expression in the form of a 'behaviour' is from the majority, it is still human behaviour, and therefore, normal - the behaviour may be unhelpful to the majority, nevertheless, it is just human behaviour.

Unless a psychiatrist can read every single thought in the mind of a patient, the psychiatrist can never claim they understand behaviour and neither can they predict future outcomes of behaviour.

Only science can find the answer to ME, it will never ever be discovered by psychiatry, the only outcome with the findings and beliefs of psychiatry is the dangerous incorrect use of medication, stigma, a downgrading of status in the individual concerned and their continued suffering.

Psychiatry will continue its agenda of applying as much confusion and blurring of statistical analysis whenever the subject of ME is mentioned in any situation. This has been a deliberate tactic for the past 20 years.

Questions must be asked of psychiatry - blind acceptance from successive UK governments of their interpretation of ME has not moved forward since its' first presentation so many years ago - it is no closer to finding an explanation of ME nor is it any closer to presenting a treatment. We must ask ourselves why has psychiatry been granted authority over scientific research? The NHS and NICE are perfectly happy to allow and protect the status quo. Why?

Recently I heard an excellent and inspirational quote on the steps outside a UK court,

"Justice has no expiry date"

We should adopt this quote and use it at every opportunity in the faces of the psychiatry 'experts' that block medical research - Wessely accuses people with ME giving him a hard time,....... shame, my heart bleeds.

max