The 12th Invest in ME Conference, Part 1
OverTheHills presents the first article in a series of three about the recent 12th Invest In ME international Conference (IIMEC12) in London.
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No Reduction of Severe Fatigue in Patients With Postpolio Syndrome by Exercise Therapy or CBT

Discussion in 'Other Health News and Research' started by Kyla, Aug 21, 2015.

  1. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    http://www.ncbi.nlm.nih.gov/pubmed/26253175#

     
  2. adreno

    adreno PR activist

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    Fixed.
     
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  3. A.B.

    A.B. Senior Member

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    Maybe this is why CBT failed to "work" as it usually does? I'm wondering why it suddenly fails when it seems to "work" for almost anything.
     
    Last edited: Aug 21, 2015
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  4. alex3619

    alex3619 Senior Member

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    Magical thinking is alive and well it seems. This is, in my opinion, what the philosopher of science Lakatos calls a waning research program. Its stagnant, achieving nothing, but they still go at it. Next time they will get it right. Next time they will score big. Next time they will hit the jackpot. Oh, wait, that's gambling addiction. Hmmm, is there a difference?
     
  5. Scarecrow

    Scarecrow Revolting Peasant

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    Excuse me for being a bit thick but how can you single blind this? I can understand it being blinded to the data analysers but surely both patients and therapists must have had a clue as to what was going on? The article is behind a pay wall.
     
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  6. alex3619

    alex3619 Senior Member

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    Its also probably not controlled in the strict sense. They have a comparison group, which is probably not quite the same thing.

    There is no way to deliver sham treatments in these things. It cannot be done. I would also like to know what they mean by single blinded. Did they mean that the people interpreting the results did not know which group a patient was in?

    No psych study using this format can ever be gold standard - double blinded randomized placebo controlled trial. They can however use objective outcome measures. This is probably the only way this kind of study can achieve high reliability.
     
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  7. A.B.

    A.B. Senior Member

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    The only way I can make sense of this is that researchers filled out questionnaires for the patients while asking them the questions in the questionnaire, while being unaware of the treatment the patients had received.

    ... which might be a very good explanation as to why the usually good results are absent :D
     
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  8. Esther12

    Esther12 Senior Member

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    Maybe some independent researcher assessing fatigue levels. Interesting.
     
  9. JaimeS

    JaimeS Senior Member

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    That is likely. They were given a stack of survey responses that were numbered and lettered, but they had no idea which patient was in which group. It is single-blinded because of course the patient knows what they are receiving in terms of treatment.

    -J
     
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  10. Effi

    Effi Senior Member

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    So it's ok if the researchers are biased I guess. How else would they be able to massage the findings to get the outcome they want? *cheeky*
     
  11. Effi

    Effi Senior Member

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    I've been seeing this more often lately, studies connected to the lack of efficacy of CBT, and then subsequently studies that explain why it's not working. The outcome being somewhere along the lines of: can't blame everything on the patient, but instead blaming the partner, family or the general social environment of said patient, for their too high/too low/otherwise faulty expectations. Anyone else notice this?
     
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  12. JaimeS

    JaimeS Senior Member

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    This is not single-blinded if both parties know exactly what they're doing!

    Full text is on Research Gate - downloaded there already, I didn't even need to ask for it.

    It was, in fact, the investigator who was blinded, not the patients.

     
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  13. JaimeS

    JaimeS Senior Member

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    This essentially reads: at the end of CBT, people were more emotionally damaged by the therapy than were controls.

    -J
     
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  14. Effi

    Effi Senior Member

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    sounds about right :rofl:

    btw one of the participating universities (Radboud) is a very big fan of 'it's all in the mind'. They even prescribe CBT to fatigued cancer patients in remission (up to 40% of patients in remission feel fatigued!). They say that the fatigue these people feel has no link whatsoever to the the treatment they received, no matter how agressive it was or how long they had to endure it. They say it is caused by feelings of sadness, too much or too little exercise, bad sleeping habits, etc. So I'm not sure what their agenda might be behind this study. Could be anything, really...
     
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  15. JaimeS

    JaimeS Senior Member

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    Link, please! I want evidence of this horribleness.

    Though keep in mind these guys are saying that CBT and its ilk do not actually work. I should think they are going against their evil overlords.

    [Edit: never mind; I found where they prescribed CBT to cancer patients; they mention it in the article. Wow.]

    -J
     
    Last edited: Aug 21, 2015
  16. Effi

    Effi Senior Member

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    It's in Dutch: https://www.radboudumc.nl/Zorg/Afdelingen/nkcv/Pages/Vermoeidheidnakanker.aspx

    I google translated the most important part (with a few touch ups by moi):
    It's pretty much the same story that they tell about cfs - there could be a biomedical stressor, but the persistance of the fatigue is pretty much caused by our own little selves.
     
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  17. A.B.

    A.B. Senior Member

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    Few patients (13%) who are sufficiently fatigued and without comorbidities were actually interested in participating in this study.

    Compared to the control intervention, exercise therapy and cognitive behavioural therapy have a problem with patients dropping out. Figure 1 tells us a bit more about that. In the ET group, 1 patient withdrew consent, 8 did not complete the treatment. In the CBT group, 5 did not start with the treatment, and 3 did not complete treatment. The reasons given seem relatively innocuous but it's strange how the control intervention didn't have the same problems.

    These therapies are clearly not popular among patients (what else is new?).
     
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  18. JaimeS

    JaimeS Senior Member

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    @Effi ,

    &*%$(*&(*$

    Sorry, but a keyboard smash was the only thing that could accurately capture the horribleness.

    Let's start from the supposition that they are generally correct. Look, I'm sure that there are people with serious illness who really worry a lot about it coming back. They should clearly seek psychological help for such an unreasonable and pathological way of thinking. I mean, their fears are totally unfounded. It's not like cancer could ever come back: once you're cured, you're cured. Everybody knows that. :rolleyes:

    It's equally pathological to give your body time to heal. Every doctor knows that there are only two states: at death's door and entirely well. There is no 'recovery period'; there is no 'regaining one's strength'. Once you've been declared cancer-free, you should be at work, preferably later that day. :rolleyes::rolleyes:

    Okay, okay, / sarcasm.

    I'm amazed at how much of psychology is still purely Freudian. This idea of psychological treatment for normal human response to trauma and illness is really weird. (Freud did not believe that neuroses could exist in the mentally well - you were either entirely mad or completely sane.) But of course, if they didn't pathologize everything, they could be out of a job.

    Meanwhile, due to the fact that cancer treatment isn't a walk in the park, I'm surprised there isn't something called 'post-cancer fatigue syndrome'. I'm sure that the immune system is pretty well smashed afterwards, and may never recover. But note that nothing I argued above assumes this to be the case.

    -J
     
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  19. A.B.

    A.B. Senior Member

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    Coincidentally, I recently read that psych studies on cancer patients also have big problems finding enough interested participants. The commonly held belief that cancer patients are generally terrified is wrong. Most cancer patient also view their psychological reaction to their circumstances as normal and not something that has to be treated. The remaining patients that are so few it can be hard to recruit enough for a study. Unfortunately I don't remember the title of the article, but that was the gist of it.
     
    Last edited: Aug 21, 2015
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  20. lnester7

    lnester7 Seven

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    I think we have to do the following. Get a CBT proponent, give them the Flu, then get another CBT proponent and start the session.

    Flu therapist: I feel like $hit
    Therapist 2: Nope, is all in your head. You need to improve your take on the flu. Have better attitude.
    Flu therapist: FU! you are telling me this join pain is in my head and that I have to push through this tiredness.
    Therapist 2: yeap go to work and move on, have better attitude.
    Flu therapist: (I just wonder what the result would be).

    THIS IS SO INSANE. In what world can you convince a person w MOno like or flu feeling that is all in your head. I think we need to submit every CBT proponent to it while they suffer the worst virus of their live. And that is giving them only one symptom!!!! While we have all the other crap: the lack of sleep, tingling, inability to be vertical, diarrhea, running on -30% of blood and so on!!!!
     
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