Psychiatrists Invent health preoccupation disorder

Psychiatry has now decided to invent and propose the addition of some new disorders to their ICD11-PHC DSM manual. Among them is 'health preoccupation' disorder. This would basically allow them to diagnose anyone with any disease as mentally ill if they are experiencing symptoms that are not considered 'normal' for a particular condition. This will especially effect people with diseases that are poorly understood and have no widespread clincially available biomarkers such as ME.

I've done a post on these classifications and some of my experience of the St. Bartholomews NHS service:

http://findanswerstome.blogspot.com/2012/07/psychiatrists-put-their-label-on-poorly.html

I was also unfortunate enough to have had a one on one consultation with Trudie Chaulder Professor of CBT (it sounds like such an expert and mind-bogglingly technical field to specialise in!). I will aim to write about this next time.

thanks,
energyoverload

I look forward to it ;-)

That is the same conditions that Somatic Symptom Disorders will allow the practitioners to apply.

This is the direction that 21st Century Eugenics is taking. Psychiatry has embarked on a determined and well funded 'land grab'; a territorial invasion of other medical disciplines, because psychiatry has no credible theories left, and no credible treatments beyond medication. When 21st Century Psyches say the word 'multidisciplinary' - what they mean is the practice of forming alliances with/invading other medical disciplines, and then taking over.

The idea that Psychiatry and Neurology should merge will take us back to the 19th Century -

Much of psychiatry is clearly bankrupt. What is their cure rate? Like other chronic illnesses they operate in ignorance, using outdated and potentially dogmatic theories. If they had been serious they would have objectively verifiable mechanisms, and achieve cures. Failure to achieve that shows just how much in the dark ages psychiatry still is. Its neuroscience, immunology etc. that offer the way forward. Bye, Alex

PS As I have said elsewhere, CSSD and similar bypass the restriction of one diagnosis under ICD, that is a diagnosis cannot be placed in multiple locations. So they have created tack-on disorders to add to other diseases. Since there is no way to disprove them, we are considered sick without objective evidence. They reject ME and CFS as objective diagnoses due to a claimed lack of objective evidence (which is now very very untrue) and yet they have similar or worse problems with evidence.

Could we submit other syndromes to their process. I quite like the idea that they should include Dr Yunus's Disturbed physician syndrome

Add ME to that definition and perhaps we could run some randomised controlled trials which CBT to try to change some doctors unhealthy cognitions about disease.

A subclass of this could then be panicing paediatrician syndrome where a doctor is so shocked at how ill a patient is with ME panics and does all kinds of damaging stuff, Like starting child protection proceedings (to enforce psycriatric treatment) or relabelling the diagnisis as persistant refusal syndrome.

This is my personal experience with psychiatric drugs:

2003- As a practicing full time hemato-oncologist, a drug rep. tries to convince me that my patients with cancer have depression (not a normal emotional reaction to their physical illness) and therefore should receive an antidepressant.
I kick her out of my office.

2005- I am hospitalized in the ICU and seem to fully recover after a 3 week hospitalization.
A few days after I return to work, I crash again. My neurologist at that time tell me how hard it is for him to see me so depressed, and therefore prescribes an antidepressant. He says-take this and it will make you feel much better.
I am too depressed to think about it or argue with him so take his advice.
My husband goes to pharmacy and brings me back a box that looks like a candy box with pills that look like bubble gum. I read the leaflet and it says that there this innocent looking medication can initially lead to suicide thoughts, tremor, worsening of depression etc etc. I throw the box into the bin.

2007- my pulmonologist thinks my life is in danger but refers me to the neurologists for management, and the neurologist recommends emotional support as "treatment". My fear of dying from my illness is translated into threat to commit suicide.
The psychiatrist I see (fortunately) doesn't think I am thinking of committing suicide, but has no doubt that I am "anxious" and "depressed". She prescribes anti-depressants. I tell her that I don't think I need them. She says that if I want to suffer that is my problem. I feel trapped because if I agree to take them it may be the ultimate proof for my "emotional problems" and also could make my condition worse and if I don't agree, I am refusing psychiatric treatment. Fortunately, the psychiatrist agrees that it is not a good idea to mix possible side effects of a non-essential medication into the "unexplained neurological disease" that I have. She is even ready to write that I have an adequate emotional response to what is going on after she sees my attempts to continue my life and receive proper medical care. She (fortunately) doesn't think I have conversion disorder but a true neurological illness. ( her opinion doesn't count because I am told by the neurologists that she is not the "right" psychiatrist to go to as she does not have a good understanding of those diseases, but that's a different topic).

2008- My illness is diagnosed as MuSK myasthenia, and there is objective proof for my respiratory muscle involvement. I am by now on respiratory support, but it is not adequate, so have many days in which I feel I am about to suffocate. I am referred to an "expert". Instead of adjusting my respirator he asks me if I am taking antidepressants. I ask him why. He explains that someone with such a severe illness should be taking antidepressants. I am not sure any more if I have come to see a psychiatrist or a respiratory expert. I beg him to check the settings of my respirator. He takes a brief look and says-they are just fine. Fortunately, a week later I am hospitalized under the care of someone who does know, and she makes the required changes.

2009- After I manage to return to work (even if very part time) I have a severe exacerbation of my illness and become nearly bed-ridden. I have severe breathing difficulties and want my wishes to be known (in case I suffer irreversible anoxic brain damage during one of those episodes) The home-care physician comes to see me and suggests anti-depressants. When I refuse to take them and demand proper respiratory care he says- You are the patient now, and I am your physician so you have to obey what I say. He then says- I am sure that you have had very ill patients who were depressed and I am sure you have done the same. I tell him that he is wrong and I have never prescribed anti-depressants to any of my patients. He looks surprised and asks-then what have you done with them then? I reply- I talked with them and honestly discussed their concerns, I gave them the confidence they required that I will be there with them what ever happens. He looks at me with disbelief and says-I don't have time for that. I find someone else to help me and gradually become an expert of my own illness.

I had to reach the inevitable conclusion that the drug rep. I kicked out of my office, had quite a bit of success with quite a few of my colleagues.

Physicians, by definition either have- "Health preocupation disorder" -if they keep updated with the medical literature, think about their patients etc.
Or- "professional neglect disorder", if they do not do all of the above.

I personally prefer those that suffer from the former to take care of me.

Psychiatry strikes me as having lower standards of evidence and also being several decades behind other areas of medicine. Others on this forum have also argued that psychiatry does not make many advancements of its own, these are usually imported from other areas of medicine and science. Interesting about Yunus' "disturbed physician disorder" regarding FM. A while ago on another thread I came up with Insufferable Psychobabbler Disorder (IPD). Since then I worked on some criteria for my own amusement.

This is half-serious and half-fun, based on online observations and reading the literature. Some of these characteristics may be very similar or overlapping or even redundant, but since when did that stop anyone publishing a criteria or questionnaire? I will admit a few of these were inspired by my own experiences as someone who was into the mindbody paradigm in my youth and was dealt with a hefty reality check by illness. At least for me, having mind over body beliefs and attempting to change thought patterns, these can in some scenarios aid mental health when one has the energy, but it seemed useless for helping underlying CFS. However, I never felt a cruel glee to blame the patient for their suffering, I was more into the sense of (illusion of) control than the just world theory.

Insufferable Psychobabbling Disorder (IPD)

• Use loaded-language rich in psychological terminology, weasel wording, non-sequitors, routinely confusing correlation for causation, and ignoring possible confounders.

• Exaggerated estimations of how much power the mind has over the body, but still distinguishing oneself as miles apart from all those 'gullible' new agers and CAMers.

• Faith in the common sense of outdated and current concepts of psycho>somatic mechanisms, irrespective of the evidence and previous smackdowns throughout history.

• Vague appeals to psycho-neuro-endocrino-immune interactions as the routine gap-filler to explain the quasi-magic and uncertainties in the hypothesis.

• Confuse simplistic models or basic understanding for advanced Einsteinian elegance and sophistication worthy of acknowledgement and praise.

• Naive generalizations or blanket applications to entire populations, with disregard for fundamental issues such as case definition and study methodology.

• Grandiose sense of discovery/illumination/importance, presenting pure speculation and hypotheses as obvious fact, apparently oblivious to contradictory evidence.

• Dismissive or heavily critical of biomedical research into conditions like ME/CFS while uncritically accepting dubious psychological and behavioural studies as solid research.

• Showing no signs of learning anything after pet claims have been successfully challenged or refuted numerous times, and keep giving life to zombie arguments.

• Claim that criticisms are borne from misunderstandings about the mind-body connection, the stigma of mental illness, and not liking to hear the harsh truth.

• Position oneself as a proponent of rational skepticism and CAM busting, while looking the other way on the issue of psychobabble (except when it is related to CAM).

• Lack of insight into one's own psychobabbling, with assumptions that having a basic understanding of science and philosophy makes one immune to cognitive biases.

Sorry to hear of all the awful experiences but just very relieved I gave my Docs a wide berth realising they knew nothing about ME.accepting only Thyroxine and a short course of Neurontin for pain (and ran - sort of) from the 4 very junior Docs and the psycho they produced in Accident and Emergency. The creepie crawlies have infiltrated real medicine at root - education includes "all in your mind" as an acceptable diagnosis. (TC is a psychiatric nurse - no Doc).

First: do no harm

The Spanish Inquisition had limits on how it could torture people, because they had to be "good Christians" and not spill blood...perfectly ok to tear folk's limbs out of their joints though.
i.e. it's amazing the mental hurdles some sick batsards will come up with to get around mercy, common sense and facts, isn't it?

Se also how several high profile psychiatrists were proven, and iirc, convicted/lost medicla licences for taking huge bribes from the pharma corops.
No damn difference to a drug dealer pushing heroin and cocaine on the streets: make a market! Push that powder! make that cash!
These are dangerous drugs, some addictive and the victim doesn't know they are being turned into a "buyer" and maybe a junkie/sick/dead victim.
Evil sons of bitches
Psychiatry should be destroyed, root and branch, as when something is that infested you burn it down in toto: it's beyond saving.
and NO I am *not* not taking about violence before anyone thinks that! Jeesh
talking about major legislation, criminal investigations, disbanding/banning of all psychiatric medical groups etc
There are decent psychiatrists, but the system is an abomination and must be wiped clean, and rebuilt, some how, completely "clean", far from an easy task.

Always appals me how folk cannot see the evil lurjing and commited aorund them, until they are forced to walk through Belsen or the like, listen to the perverse hypocrisy of priests claiming excuses to cover up child rape or reasons to torture and bomb others, etc
One day, decades form now, folk will look back on this in horror as they do now regarding the barbarism and stupidity of the "Bedlams", "Bleeding" etc
Lobotomy, electroshock therapy, castration/hysterectomy for "control" were beloved of psychiatry, totally disproven, quackery! Inhuman BULLSH*T!
And who were usually the biggets proponents of Eugenics? Often it was Psychiatry...
Seems to me the field attracts sociopaths and inhuman demagogues like turds draw flies!

Psychiatry is run by psychopaths.

This is basically "gas lighting" patients, altering their thoughts, perceptions into thinking all their problems are psychological.

Sickening

A few years ago I happened to have the radio on during a call-in show on the topic of bullying. A woman called in who identified herself as a psychologist -- and a bully! She said she had chosen psychology as a profession so she could bully people. She then proceeded to try to bully the show's host, and he quickly cut her off. Chilling to listen to her. I wonder what damage she has done to people who came to her for help.

This will not be a popular post, but I have worked alongside some good psychiatrists (and some very bad ones). Dealing with severely ill or pyschotic patients is not easy work. Psychiatry has always been bedeviled by faulty and irrational beliefs and treatments, and a psych worth their salt will ruefully acknowledge that imprisoning for life significant numbers of the population without trial, insulin coma, ECT,ice baths, and the widespread use of the 'chemical cosh' to sedate inpatient populations are clearly measures of control, rather than medicine. The whole DSM thing is screwed, because any diagnosis that tells you nothing about causation, progression and prognosis is useless. But....that doesnt mean we should kick into touch the attempt to heal people with mental illness. Mental illness kills as does physical; bipolar and anorexia are good cases in point. There was a point in the 70's and maybe 80's when psychiatry in the UK had a chance to really get with it, and look at what its purpose was. It flunked the test, and stuck with labels and pharmaceuticals because they were the safer and better rewarded option. But to demonise the whole profession puts us in the same reactive and limited mind set as them. And I dont want to be them.

Don Quixote, thanks for sharing your story - it moved me, and I feel a great respect for your ability to refuse all the attempts to fill you full of unnecesary anitdepressants

Psychiatrists have a very hard job. How do you fix something as complex as a mental illness when they dont even have objective diagnostic tools? How do you even do good research?

One of the problems though is that the medical system as a whole, not just psychiatry, is not sufficiently self correcting. Bad theories are not abandoned, they linger. Treatments with poor outcomes are still out there. The whole medical profession, not just psychiatry, shares part of the blame, as do the supporting institutions. Its a failure all around. Having said that, individual doctors do not have much blame. The system is designed to make it hard for individual doctors to change this, or even challenge them. For a start, how many doctors have the time to properly research the issues? If they dissent and practice medicine differently, how long before they are officially censured?

This is a deep and complex problem, well entrenched in society - just look at the raft of laws and legal precedence privileging doctors (including psychiatrists). In court cases a psychiatrist's testimony is based on opinion not objective diagnosis. I do not think that psychiatry deserves the same standing as regular medicine. Its a tough discipline to practice in, but it does not have the evidence base of regular medicine - and regular medicine has a very limited evidence base, so much of it is probably wrong.

Bye, Alex

I think the very phrase "Mental illness" is wrong, I'll state up front that I don't believe in mind/body duality. It is akin to ancient people coming up with ideas such as sun gods to explain the perceived movement of the sun across the sky.

We know better now, so the term can be discarded. The damage caused by the stigma and myths surrounding the term is insurmountable.

the funny thing is the more disorders they invent the less people are going to believe its any type of science/medicine. i think they are slowly digging their own grave which is probably a good thing as i think most of their stuff is a load of crap.

I believe people can have mental health issues but i dont think they are really looking at the cause of these things which i think many are physiological and require more then a script for ssri's and positive thinking and loving yourself and all that sort of crap.

Cool! Can I have this?

There struggling to get cfs recognised as a mental health disorder because of the good research coming out with ritux etc etc, so the next best thing is they could classify someone with cfs as 'health preoccupation disorder'