New Scientist: Metabolic switch may bring on chronic fatigue syndrome

[Grigor]

Very true. Maybe I was trying to put a positive spin on that shitty sentence in the end.
But again. Good article.

 

[user9876]

As @Sasha says, this line is only ever used by people who believe the illness they're discussing is largely psychological. Its a fudge used by the psychobabblers to reclaim an illness as psychological, even in the face of some evidence of a biological basis. If anyone questions it, they can back peddle by saying "well, every illness has a psychological component'

If that's true, then its meaningless to say it at all. It is said because a clever coded way to make it impossible for us to object to psychological explanations of our illness.

The clue here about its purpose is that the statement almost never said about "physical" illnesses (as Sasha says). Do you ever hear people is "there might be a psychological component" to HIV? Cancer? Brain injury? Multiple burns? No, of course not.

I actually think its not necessarily true that every illness has a psychological component. Every illness may cause a psychological reaction - but that's not what they're claiming, is it? The statement implies people can make their illness worse by feeling down or anxious, and better by having a positive attitude. I think we might find that's not the case for most illnesses (other than perhaps mental illnesses). Otherwise, you could get better just improving your attitude. And that doesn't really happen for many illnesses.

It is really not a phrase that a scientist would use (unless doing some strange proof) it is to vague to be meaningful or useful. Do they really mean to add to the definition of an illness a large (and potentially infinite) disjunction of all the ways that an illness maybe effected or effect someones psychology because that is what they are doing. Nobody and especially reviewers should accept such sloppiness. If they mean a mechanism or a well defined set of mechanisms then they should specify - otherwise they should go away and think more until they can specify accurately. Then their theories can be assessed.

 

[Snowdrop]

I can shorten my post by saying-- what @Woolie said.

The article was a pleasure to read.

But we do need to proactively grapple with these moronic statements. Saying that something has a psychological component is very vague (as mentioned also) and therefore meaningless. It's put there so that it will imply things that cannot be substantiated.

There is so much popular belief in this. It gets repeated throughout media as self-evident. But what is being said and also implied is not backed up by enough or very good science. And it's complex--I've heard people use this to justify the position. It may even be that some statements turn out to be true but you can never prove or disprove something so ridiculously vague.

Any interplay between mind and body can only be validated with very specific and limited statements, as in, in this situation under these conditions with certain precondition factors and so on.

BPS have set themselves up for what they see as a no lose scenario. Doesn't matter how biological something is there is always that psychological factor and they have treatment that will improve health every bit as much as any biologic treatment model.

The mind-body brigade needs to be constantly held accountable for false statements, statements that overreach known fact, and treating gut instinct as science.

 

[JES]

Is this illness some form of diabetes?

Edit: I'm probably misusing the word, is diabetes a term for a metabolic disease revolving around blood sugar regulation?

CFS/ME patients don't seem to suffer from hyperglycemia like diabetics, but what I've heard a lot is people having hypoglycemia or reactive hypoglycemia, which could indicate some problems with glucose / sugar control. Maybe that has some connection with the theory of Fluge & Mella.

I get this type of hypoglycemia quite easily, for example any type of slight exercise after a meal typically worsens it. Also blood sugar reducing supplements that are usually quite well-tolerated like ALA make me very hypoglycemic, so much that I can hardly stay awake.

 

[Barry53]

However, he adds that psychological and brain chemistry factors might be involved in some cases.

[my italics]

I think this simply covers the possibility that some cases might be misdiagnosed, especially as an accurate diagnostic is as still yet a work in progress. I do not see it as anything more untoward than that. The word "involved", and the phrase "in some cases" I think are carefully chosen.

 

[TiredSam]

Is this illness some form of diabetes?

Edit: I'm probably misusing the word, is diabetes a term for a metabolic disease revolving around blood sugar regulation?

Can't possibly be:

http://www.independent.co.uk/life-s...hose-with-depression-there-would-9924174.html

Also what on earth makes him say that CFS doesn't exist in France, Sweden, Germany?

Ignorance I would imagine, plus the fact that he likes to park his head up his arse when he isn't ranting about ME patients. If he had ever bothered keeping up with the "bio" in biopsychosocial he would have heard of the splendid work of Prof. Carmen Scheibenbogen at the Charite (University hospital) in Berlin, and could even have bumped into her over coffee at a IIME conference. Mind you to be fair, most of the estimated 300,000 ME patients in Germany don't know that he exists either, or of his responsibility for their suffering.

 

[Barry53]

Ignorance I would imagine, plus the fact that he likes to park his head up his arse when he isn't ranting about ME patients

Oh, I think that is especially where he has it parked when ranting about ME.

 

[Sasha]

In general, I thought the article was very good, and I think the "psychological" mentions will appear as odd tag-ons. It's annoying that the issue has crept in but I think it's not surprising, given the UK's history on this, and the general theme of the article is that this is an organic disease.

I think this is a big deal, given that this is the New Scientist and that it wasn't long ago that they were uncritically publishing other angles. They've published good info now and it will reach a very wide audience.

 

[PhoenixDown]

http://www.curiousread.com/2009/03/how-people-can-think-themselves-sick.html

How successful is your treatment of CFS?

Roughly a third of people completely recover and a third show good improvement. About a third we can't do much for.

Perhaps that's because a third actually have ME where as the rest had chronic fatigue or something else.

 

[BruceInOz]

https://www.newscientist.com/article/2121162-metabolic-switch-may-bring-on-chronic-fatigue-syndrome/

Together, these metabolic approaches are suggesting that CFS has a chemical cause. “It’s definitely a physiological effect that we’re observing, and not psychosomatic, and I’ll put my head on the block on that,” says Armstrong. However, he adds that psychological and brain chemistry factors might be involved in some cases.

Since nobody seems to like the closing sentence, maybe @ChrisArmstrong can comment on whether New Scientist quoted him accurately or expand on what he meant?

 

[Cinders66]

How successful is your treatment of CFS?

Perhaps that's because a third actually have ME where as the rest had chronic fatigue or something else.

Given Wessely would be assessing community size at at least 600,000 why was it accepted that the third for who they couldn't do much - 200 000 people double MS size - would have nothing done to help them? CBT /GET don't help lots and aren't curative for lots and yet they're all uk really has funded

 

[Barry53]

Since nobody seems to like the closing sentence, maybe @ChrisArmstrong can comment on whether New Scientist quoted him accurately or expand on what he meant?

As I said earlier, I do not see a problem with it ...

I think this simply covers the possibility that some cases might be misdiagnosed, especially as an accurate diagnostic is as still yet a work in progress. I do not see it as anything more untoward than that. The word "involved", and the phrase "in some cases" I think are carefully chosen.

I would be amazed if, given current diagnostic limitations, some ME diagnoses are not, so some degree at least, misdiagnosed. That final comment simply allows for such a possibility, so I do not see any need to get hung up about it. If the statement has been made objectively for that sort of reason, then it would be wrong to ask for it to be removed.

If it were a mis-quote then that is another issue, but even if it is not, given what I say above, I have no problem with it. Objectivity and seeing the wood for the trees is crucial.

 

[KME]

I'm kinda liking the idea of scientists willing to put their heads on the block for us. Cheers, Armstrong.


Journalistically, I understand the need to show both sides of the argument and perhaps stir up interest in one's article by ending on an odd/controversial note. It's also completely reasonable that Armstrong said this (I'm going to assume he was quoted accurately), if just a little unfortunate under the circumstances. But here's the thing - Armstrong said this, in my view, because he sees complexity, sees the exceptions, is keen to be truthful and accurate and comprehensive and not overly simplistic in what he says. This is how I like my scientists, and it's how I like them to talk to the media, even if some readers find that confusing. PACE authors on the other hand, tend to give a lovely, simple story to the media. Have you ever read a report where one of them has said that biological factors (other than those resulting from deconditioning, grrr) may play a role in some cases? Has one of them ever said that some cases have no psychosomatic component? Never mind most/all cases. (Rhetorical.)


I do think that in general it would be helpful if scientists were careful, or rather, media-savvy, about what they say when it comes to these psych questions, so that less discerning readers don’t get confused, but I’m also aware that they’re not in control of how what they say is reported. It's possible that the journalist asked him "Are you saying that psychological factors or brain chemistry do not play a role in a single case of CFS? Not a single one? Not one?" and that he answered (hypothetically) "No, they could be a factor in some cases." It's also possible that he's referring to the kind of psychopathology seen in some patients with neurological diseases, e.g. anxiety in some people with Parkinson's, which seems to be part of the Parkinson's/disease process rather than a reaction to it. Since we don't know how he meant this, I'm not reading anything into it, particularly given his very clear statement that it is not psychosomatic. He couldn't have been clearer on that.


As long as they keep doing the work, finding key pathophysiological factors that will lead to effective treatments, I’m happy. When we improve with immunomodulators/other treatments, that will speak for itself. ‘Cos rituximab isn’t known for its faulty-illness-belief-modulating activity.

 

[Tyto alba]

Perhaps the absence of quotation marks around the final sentence provides a clue to whether that was a direct quote, or simply the authors interpretation?

 

[Barry53]

@KME I am with you on this. Especially as journalists cannot help perverting context at times, as you give a possible example of.

 

[Woolie]

Saying that something has a psychological component is very vague (as mentioned also) and therefore meaningless. It's put there so that it will imply things that cannot be substantiated.

Yea, wot @Snowdrop said....

 

[Sasha]

The paper edition is out today and this article is on page 10. The story is also one of three featured on the title line on the cover: "THE OFF SWITCH: What really goes wrong in chronic fatigue syndrome".

Thank you, New Scientist!

And all those who were interviewed!

 

[John Mac]

Here is a link to the front cover picture

https://www.newscientist.com/issue/3113/

 

[AndyPR]

@Sasha , can you see if there is any difference in the text of the article between the online and printed version? No real reason for asking, just curious.

 

[Belbyr]

The paper edition is out today and this article is on page 10. The story is also one of three featured on the title line on the cover: "THE OFF SWITCH: What really goes wrong in chronic fatigue syndrome".

Thank you, New Scientist!

And all those who were interviewed!

Could you provide a link for reading? Sorry, brain fog...