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Psychosomatic disorders - Synonyms

Discussion in 'Other Health News and Research' started by Bob, May 8, 2013.

  1. Bob

    Bob

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    I've decided to include a new list, as follows:

    List of terminology that has been used to describe ME:
    (e.g. "functional somatic syndrome")

    All in the mind.
    Behavioural disorder.
    Burnout.
    Neurasthenia.
    Functional disorder.
    Functional somatic disorder.
    Functional somatic syndrome.


    Can anyone help me with it please?
    Are there any terms from the original list (see opening post) that should or should not be included?
  2. Valentijn

    Valentijn Activity Level: 3

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    Wessely's done a few papers equating neurasthenia to ME. He's also equated it with burnout, as do many Dutch papers.
    Bob likes this.
  3. Forbin

    Forbin Forbin

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    "False illness beliefs."

    I'm not sure of the exact origin or "official" nature of this term, but it does show up quite a bit.
    Bob likes this.
  4. Hip

    Hip Senior Member

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    This definition is useful:
    This webpage summarizes most of the terms you have listed, Bob: Textbook of Psychiatry/Somatoform Disorders

    I'd suggest that this equating ME/CFS to burnout and neurasthenia may be correct — except that the cause of these illnesses is very likely an infectious one. I think that high fliers that suddenly got burnout, and quit their jobs, picked up a virus that entered their brain, and caused the burnout.

    Highly paid high fliers in the 1980s (the decade of "yuppie flu") often followed a high living lifestyle of sex, drugs, and rock'n'roll. The drugs, and rock'n'roll probably were relatively harmless, but the pursuit of sex and amorous encounters is I suggest is where they most likely picked up a respiratory virus that then precipitated their burnout. I caught the virus that led to my ME/CFS from kissing on a date.

    Burnout is always blamed on stress at work, but in fact when you are healthy, this stress is invigorating and exciting. Only once you develop burnout from an infectious cause does everything suddenly appear stressful.

    Wessely's (completely crazy) view is that ME/CFS and related conditions are simply caused by a person having false illness beliefs. Wessely thinks that ME/CFS patients have inadvertently started to believe they are ill, and because of this belief, they then actually become ill. In other words, Wessely says there is no biological cause to ME/CFS, just I psychogenic cause: namely that some aberrant beliefs you hold about being ill actually make you sick.

    Of course there is no evidence for such psychogenic causes whatsoever. Nobody has ever succeeded in planting a belief about being ill into a person's head, and then having that person come down with the illness. This never happens.

    I wouldn't mind if Wessely kept his ideas to himself, or confined them to within his circle of unscientific psychologist friends, otherwise known as the Wessely School. But the problem is that Wessely School psychiatrists have advised the UK government, and so his views have become widely adopted, much to the detriment of the more scientific and evidence-based views on ME/CFS, such as the viral etiologies of ME/CFS.
    Sidereal likes this.
  5. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    I think he argues more that these 'false illness beliefs' are what keeps people ill rather than what makes them ill initially.

    Stress at work isn't invigorating or exciting if the work is mind-numbingly boring and pointless and you are just being pushed to do too much of it. I have direct experience of this!
  6. Kina

    Kina Moderation Team Lead

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    Here's a new term to consider and apply to those like Wessely -- 'false patient beliefs'. Treatment for said problem -- CBT.
    Little Bluestem and Valentijn like this.
  7. Valentijn

    Valentijn Activity Level: 3

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    After getting diagnosed with ME, I was sent to a fatigue/burnout center. I saw only two patients there that had what I had (one needed a scooter and the other had the same issues with the stairs). Most were fashionably dressed young women, wearing make-up, some with a young child in tow. Maybe -some- burnout is ME, the same way that some fatigue is, but the label is applied so widely that it would completely false to say they are the same - especially since neurasthenia and burnout are psychological by their current definitions.

    That's not to say that people with ME or other physiological illness aren't diagnosed as having neurasthenia or burnout. I am absolutely certain it is happening frequently.
  8. golden

    golden Senior Member

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    Would the phrase:

    'Not somatic'

    mean all in the head?
  9. Hip

    Hip Senior Member

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    That sounds familiar. In any case, there is zero evidence for diseases remaining in a patient due to their belief system. For example, people given antibiotics to clear up a bacterial infection never need to be given CBT at the same time, in order to update their beliefs about their state health. It is never the case that the symptoms of a bacterial infection will continue, even after antibiotics have cleared up the bacteria, due to false illness beliefs. This does not happen.

    There is no evidence from any area of medicine that illness beliefs can maintain the illness after the physical cause of that illness has been removed. Thus it is ludicrous of Wessely to propose that false illness beliefs are maintaining ME/CFS.
  10. Shell

    Shell Senior Member

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    True story: Once, during my training days when I lived in the nurses home a fellow student arrived at my door crying and very distressed. She informed me there was nothing worse than "the hyperchondriac who proves you wrong." I always remember her exact words.
    A patient on the ward had constantly complained of chest pains which had been written off by the doc as somatic in nature. To take his mind off his terrible chest pain, my friend was asked to take him for a nice walk.
    She walked him up a slight hill in the hospt grounds and he dropped dead at her feet.

    I have other similar tales to tell; though not ones that end in death for the poor sod of a patient thankfully.

    I've sat at an inquest (my friend's very preventable suicide) so I've seen how cross a coroner can get. But I've also seen that it makes no damned difference.
    When doctors can simply shrug off dead patients, nothing much will change.
    Sidereal, beaker, PhoenixDown and 2 others like this.
  11. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    Sadly such incidents are far from rare. My friend's mother died a week after being told by a doctor that her symptoms were all in her mind. The same doctor wrote off my first episode of severe, near-life-threatening hyponatraemia (low blood sodium) as a panic attack over the phone. The paramedics whom I eventually called in desperation spoke to the GP, assumed despite my protestations that he was right, and left me as they found me after exhausting me further. The A&E doctor rejected my suggestion of hyponatraemia when I was taken to hospital as an emergency case 3 years later, and sent me home. I had another attack on the way home and was rushed back and finally diagnosed - with severe hyponatraemia. It can be fatal.

    Incidentally, I was going to correct you on your use of the word 'somatic', as it was my understanding that it meant 'relating to the body'. On checking, I found that it is indeed this according to Cambridge dictionary, but some sites use it synonymously with 'psychosomatic'. Confusing!
    Valentijn likes this.
  12. Bob

    Bob

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    Yes, it's easy to get this word confused. Perhaps that's why some sites use the term incorrectly. As you say, 'somatic' refers to the body, and a somatic illness is a physical illness, not a mental illness.
  13. Shell

    Shell Senior Member

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    I wonder if the misuse of precise language is part of the game. In my work days we called physical manifestations of mental illness "somatic" but only on a very limited basis. For example, a patient with a severe psychotic depression who stopped eating because he believed he had no throat or stomach was not considered "somatic" even though he said he could "feel" the lack. But a patient with anxiety who complained of dizzyness or other physical problems would have them labelled "somatic".

    One thing I can say from personal observation (have no idea if there's research on this) but I never nursed a patient with depression, anxiety, PTSD or panic attacks who didn't know what was wrong with them. If they had something else as well; a lot had type 1 diabetes for example, (a patient with well controlled schizophrenia and type 1 D nearly died thanks to twit doctors refusing to treat her in A & E and sending her unconcious to us. Thankfully a quick BG test showed she was in a hypo coma and she was shipped back and did ok.) then they saw the differencce.
    I think we underestimate hugely the insight the patient has. If someone says "I'm not depressed or anxious" we should be taking that seriously.

    In my training it was made very clear that we must to all we could to deal with physical illness in our patients and not dismiss it as "anxiety". What the hell happened to that?
    We were also told never to write anything in a patient's notes that wasn't backed up with evidence. So, we could write down observed behaviours but we couldn't assume we knew what the patient was thinking or feeling - we had to ask them.
    Where did the idea that the patient is always lying come from?
  14. alex3619

    alex3619 Senior Member

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    somatic = of the body, hence not somatic would mean not of the body. In psychiatry that often means all in the head, though strictly it doesn't.
    golden likes this.
  15. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    It's very interesting to hear this from someone who has worked in the field. There have been reports in the news and documentaries that people with mental illness and learning difficulties are much less likely to get the correct treatment than those without, when presenting with the same symptoms and signs. I know that in the UK, once you have had any kind of mental illness, or even been incorrectly diagnosed with one, evidence of any physical illness is more likely to be dismissed.

    I have experienced both depression and anxiety, and have been very aware that I had them. I am also aware when I don't have them! I have not had depression since 1996, and have no history of panic attacks. I have also never had a neurotic condition that involves excess fluid consumption. My fluid consumption is normal. I have produced meticulously-kept fluid charts at doctors' requests. But when I tell them these things they appear to think I am either lying or don't know what I am talking about. It offends me deeply, and makes me very angry.

    Doctors also seem to find it amusing or incomprehensible that a patient may be studying medical science, as though there are two distinct species: knowledgeable doctors and ignorant, silly patients. Even when a doctor or scientist has a consultation as a patient, they can feel treated like this. This article is very illuminating on this issue:

    http://www.nejm.org/doi/full/10.1056/NEJMp078226

    Are doctors taught humility as part of their medical training? Do other types of professional develop a 'God complex' when they qualify?

    I realised how easy it was for this to happen when I graduated with one of my degrees. The transition from student to graduate was a strange one, and I thought I must now be some kind of expert, and became over-confident. I gave my best friend some information that I later realised was wrong, and told her that I had got it wrong. She said at some point that she believed everything I said, which alarmed me, and I immediately told her not to. I have been much more careful since then.
  16. golden

    golden Senior Member

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    Part of the problem is a segregation of medical students eg: special student bar etc.

    Then is the language used to deliberately confuse the lay person...which is outdated.

    Then there are 'special' NHS discounts for staff in shops etc..

    There are ridicously inappropriate wages, which again offer a superior, seperate lifestyle...

    I think ofte it serves to attract the wrong type of person to the job.

    And in the UK the patient loses all power when they do not hold the purse strings. The medics will be paid no matter what.

    I am highly alarmed by a trend of abuse towards those patients daring to complain. The tactics being usedby the medical profession to protect their poor performance is shocking.
    merylg likes this.
  17. Valentijn

    Valentijn Activity Level: 3

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    The CBT crowd hypothesized that ME/CFS patients deny mood or mental disorders because we hate/fear mental illness. That has been disproven in various research, yet they continue to push the assertion which that assumption was supporting.

    I suppose the same thing has likely happened in psychology as a whole to some extent. The sole source of wobbly support has been pulled out from under the anxiety/depression-in-denial diagnosis, yet the diagnosis itself somehow remains, floating in midair with nothing to support it.
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  18. golden

    golden Senior Member

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    Mental illness is commoner amongst Doctors than any other group in society.

    One must also see their high rates of alcohol and drug abuse too.

    Whilst I have compassion for this, it makes me wonder. This must be factored into the equation somewhere.

    One Doctor I was chatting to online some time ago had worked in psychiactric wards and had herself been diagnosed with all sorts of mental health illness. She managed to keep working.

    She told me her own symptoms remind her the most of people with M.E. In fact she hinted strongly of the connections between M.E. and rare forms of depression including the post exertional fatigue element.

    And yet her description seemed nothing like M.E. to me. (she had not been diagnosed with M.E.)
  19. Shell

    Shell Senior Member

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    Valentijn: I have to agree with you. But it rankles because even when I working in psychi we had way more seriously ill patients than we could cope with. Why in the name of all sanity would stupid Psychi folk want to rake in even more patients when they are so crap at helping the patients they already have?

    golden; It's true that doctors have a very high mental illness rate. Again that leaves me wondering why pychi medics are so keep to label everyone and his dog has mentally ill. It's like having a massive plate full of way more than you can eat and yet insisting on stealing a loaf of bread.
  20. Hip

    Hip Senior Member

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    Many people on this forum have developed depression, anxiety disorder or ME/CFS after contracting a microbial infection, and if you are one of these people, you don't need any convincing about the capacity of common microbes in circulation to cause significant physical and mental ill health. Indeed, in the last decade or two, researchers have been unearthing numerous links between chronic microbial infections and many common serious diseases.

    The virus I caught that precipitated my ME/CFS also spread to over 30 friends and family, and I noticed that most people developed noticeable memory and cognition problems soon after contracting this virus (and several developed anxiety disorder from this virus). Nasty microbes in circulation can and do permanently affect the mental functioning of people, even if they don't get a serious disease like ME/CFS.

    Now, doctors (and nurses too) are likely exposed to a far greater number of circulating microbes that most other people, because when you are ill with a fever, it's the doctor who you go to see. So I would not be surprised if doctors were themselves contracting more than their fare share of the nasty microbes. Since microbes can precipitate cognitive and mental health disorders, this could this be why doctors suffer from higher rates of mental health conditions.

    I think doctors should really wear surgical masks, like dentists do, to protect themselves from all those coughing and spluttering patients, who spread their germs around the doctor's surgery.

    Do we really want the cognitive and intellectual function of our doctors to reduced by the microbes they catch from their patients? Certainly not: that is bad for the doctor, and is bad for their patients, who depend on their doctor maintaing peak cognitive and intellectual abilities. I think more should be done to protect nurses and doctors from the germs circulated by coughing and spluttering patients.

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