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Mindfulness therapy for somatization disorder and functional somatic syndromes: economic analysis

Discussion in 'Latest ME/CFS Research' started by Tom Kindlon, Apr 13, 2014.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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    Full text is available here for free: http://funktionellelidelser.dk/file...ationer/Economic_analysis_alongside_a_RCT.pdf

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  2. Tom Kindlon

    Tom Kindlon Senior Member

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    71% of the patients had CFS.

    I don't think the abstract give a good reflection of what was found:

    Point 1:
    They have collapsed the healthcare costs from the two groups, one of which is "enhanced treatment as usual" which would usually be seen as more like a control group.

    With the Mindfulness therapy:
    One year prior to baseline: $4643
    Baseline and one year ahead: $3937

    "Enhanced treatment as usual"
    One year prior to baseline: $5996
    Baseline and one year ahead: $3355

    The baseline figures may not be average figures for a typical year: this figure was in the year in the lead up to be referred to the clinic so these were likely in the period when the patients, and indeed health professionals, were looking for answers to do with their health problems.
    Last edited: Apr 13, 2014
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  3. Min

    Min Senior Member

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    Thank you Tom.


    Can anyone point to the evidence that somatization disorder and functional somatic syndrome actually exist please?
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  4. Bob

    Bob

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    "bodily distress syndrome (BDS)"

    That's a new one for me. I can't remember having come across that term before.
  5. Tom Kindlon

    Tom Kindlon Senior Member

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    I don't think the abstract give a good reflection of what was found:

    Point 2:
    The percentages receiving disability pension increase quite dramatically from baseline:

    Mindfulness therapy:
    Baseline: 4
    Follow-up at 15 months: 15

    "Enhanced treatment as usual"
    Baseline: 7
    Follow-up at 15 months: 27

    -----
    Also, the focus on disability pension ignores the fact that most people were still getting some sort of support from the state.

    Here are the results:

    Mindfulness therapy (n=59):

    Baseline:
    Self-support: 19
    Unemployed: 6
    Sickness benefit: 21
    Flexible work: 9
    Disability pension: 4

    Follow-up:
    Self-support: 17
    Unemployed: 9
    Sickness benefit: 2
    Flexible work: 16
    Disability pension: 15

    -------

    "Enhanced treatment as usual"
    Baseline:
    Self-support: 17
    Unemployed: 6
    Sickness benefit: 23
    Flexible work: 7
    Disability pension: 7

    Follow-up:
    Self-support: 13
    Unemployed: 4
    Sickness benefit: 3
    Flexible work: 13
    Disability pension: 27

    So if one just looks at self-support, the only one that doesn't involve transfers, there is little difference:

    Mindfulness therapy (n=59):
    Baseline: 19
    Follow-up: 17

    "Enhanced treatment as usual" (n=60)
    Baseline: 17
    Follow-up: 13
    Last edited: Apr 13, 2014
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  6. Tom Kindlon

    Tom Kindlon Senior Member

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    71% had CFS.

    This involves Peter Fink from Denmark.
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  7. Tom Kindlon

    Tom Kindlon Senior Member

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  8. Bob

    Bob

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    @Tom Kindlon, thank you. I've added it to my (ever-growing) reference list:
    http://forums.phoenixrising.me/index.php?threads/psychosomatic-disorders-synonyms.23109/
  9. Esther12

    Esther12 Senior Member

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    ? There are 80 in the follow up group. How did they get more participants at follow up?

    edit: Typo there - Sickness benefit: 2 not 23
    Last edited: Apr 13, 2014
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  10. Tom Kindlon

    Tom Kindlon Senior Member

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    Cheers. Fixed that and also the PubMed Commons comment that also had it.
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  11. john66

    john66 Senior Member

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    I took the mindfullness meditation course last year. It does help to quiet the mind down and helps sleep overall. You can try some of the mediations on youtube. The key is that you have to do it for at least six weeks. After a while it became tedious to do it and I stopped, for no particular reason. I recently started again, hoping my sleep will improve. J
  12. A.B.

    A.B. Senior Member

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    I did meditation for years. It helps feeling better, but didn't change the underlying illness, which continued to progress.
  13. Cheshire

    Cheshire Senior Member

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    Ok, but the number of people receiving disability pension from the 2 groups at the beginning were slightly different.

    Mindfulness therapy (n=59):
    Baseline:

    Disability pension: 4

    Follow-up:

    Disability pension: 15

    which makes an increase of 3.75

    "Enhanced treatment as usual"

    Baseline:

    Disability pension: 7

    Follow-up:

    Disability pension: 27

    which makes an increase of 3.85


    The difference is really very subtle!! You can manipulate the numbers to make them mean very different things...
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  14. A.B.

    A.B. Senior Member

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    Both forms of treatment resulted in increased disability at the followup. Since there is no control group (of patients not receiving treatment), it's not even clear whether the treatments are helping at all. For all we know, they could be harmful. The paper acknowledges this:

    Since no treatment costs less than some treatment, for a proper economic analysis it would be crucial to check whether the treatments are actually useful. Since the nutters are not interested in reality, this was of course not done. The goal is, as usual, to promote their pet theory.
    Last edited: Apr 14, 2014
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  15. Cheshire

    Cheshire Senior Member

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    Oh!!! Just a small sentence for an obviously so important question... So patients could be right? Let us forget this unhelpfull matter quickly.
    Do these people have a brain?
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  16. A.B.

    A.B. Senior Member

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    According to table 2:

    Pension/no-pension ratios at baseline and at 15 month followup:
    Mindfulness: 11/44 and 15/44 (in percentages 25% and 34%)
    Treatment as usual: 20/33 and 27/33 (in percentages 60% and 81%)

    The percentages suggest that the mindfulness patients are very different from the treatment as usual ones.

    Furthermore, assuming that the difference in reduced health care costs between the two patient groups is actually attributable to the therapy, one cannot conclude anything about the cause. The paper wants to suggest it's because the therapy is somehow working (despite patients getting worse), but it could also be attributable to patients losing faith in the health care system and chosing to use it less, or being told their problem is psychological and that they should not go to the doctor, etc.

    Edit: nevermind about the table, I figured it out.
    Last edited: Apr 14, 2014
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  17. Cheesus

    Cheesus Senior Member

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