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the psych lobby strikes again: DSM-5 v. WHO's ICD in the US

Discussion in 'General ME/CFS News' started by fresh_eyes, Dec 22, 2009.

  1. medfeb

    medfeb Senior Member

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    At Suzy's suggestion, Cort added the COalition 4 ME/CFS response to the DSM-5 into this thread as well as the coalition call to action here.

    I think the link to the response that the Coalition submitted might have been lost in the process - at least from what I can tell. Here's a high level summary and links to both the coalition position paper and the coalition response.

    1. High level summary of the issues

    Among other changes, the DSM-5 proposal includes the establishment of a new category called Complex Somatic Symptom Disorder (CSSD). The criteria for a CSSD diagnosis include somatic symptoms that last more than 6 months and significantly disrupt life combined with the doctors assessment that the patient has a disproportionate concern about the medical seriousness of his symptoms. The guidelines also include recommendations of Cognitive Behavior Therapy (CBT) and antidepressants as the appropriate therapies.

    CSSD could prove disastrous for the ME/CFS patient and for patients with other diseases like Fibromyalgia, Gulf War Illness and IBS that are misunderstood, misdiagnosed and mistreated by the medical community at large. For doctors who view the ME/CFS patient as just depressed, it will be a small leap to decide that the patient has disproportionate and persistent concerns about the medical seriousness of one's symptoms and, as a result, inappropriately diagnose CSSD. Once diagnosed with CSSD, the implications for diagnosis, treatment, disability and insurance will be profound. ​


    2. The DSM-5 position paper with further details on the issue and the process to submit comments. This is based on the DSM-5 proposal as it exists this year (May, 2011)

    3. The response that was submitted to the DSM-5 team by the Coalition 4 ME/CFS.

    As Suzy said, each person or organization needs to submit their own comments on the web site using this process. You can either use the above materials to compose your own letter or use the letter directly.
     
  2. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    Only 8 days left!


    All published submissions that I am currently aware of are now collated on my site on a dedicated page, here:

    http://wp.me/PKrrB-19a



    For last year's (February - April 20, 2010) public review submissions, you need this page:

    http://wp.me/PKrrB-AQ



    If you are aware of submissions by other patient organizations, please let me know, via PM.

    If you are submitting as a patient or patient advocate and would like your comment published on my site, please send a formatted or plain text copy by PM or by email direct to me.agenda@virgin.net

    Please state, clearly, how you would like to be described, for example:

    Pippi Longstocking, patient (US)

    or if you chose not to be identified, for example:

    Carer of young person with ME, (UK)


    No email addresses will be published.

    Please redact any email addresses, street addresses and other personal details from the text of your response that you do not want published.

    If your response runs to more than around four sides of A4, I may post the first paragraph and place the full response in a Word file or PDF instead.

    I reserve the right to omit content which I consider potentially actionable or otherwise unsuitable for publication on my site.

    Thanks,

    Suzy
     
  3. justinreilly

    justinreilly Stop the IoM & P2P! Adopt CCC!

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    NYC (& RI)
    left comments on SSSD and CSSD again. Thanks everyone who has been on top of this!
     
  4. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    http://www.dsm5.org/Pages/Default.aspx


    DSM-5 Web Site Period for Comments has Been Extended to July 15!

    "We are extending the period for submitting comments and suggestions to the web site regarding the proposed diagnostic criteria revisions, and the newly proposed organizational structure for DSM-5. We are appreciative of the ongoing interest in contributing to this process and are extending the period for submittng comments until July 15th. This extension will also permit reviews and comments for the newly proposed criteria and approach for the assessment of Personality Disorders, which are now being uploaded to the website for release. Our thanks to those who have already provided contributions to this interactive process."

    Well, there you go...

    So, those of you who did not submit now have another 4 weeks in which to submit a response. I want to see thousands telling the APA why they need to rip up these proposals and start again.
     
  5. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    CFS + SSD, anyone?


    DSM-5 comment period for submitting stakeholder feedback has been extended to July 15!

    I want to see thousands telling the APA why they need to rip up these proposals and start again.

    Register to submit feedback here: http://tinyurl.com/DSM-5-CSSD

    Proposed criteria are set out on the DSM-5 Development site here: http://tinyurl.com/Somatic-Symptom-Disorders

    The CSSD criteria are here: http://tinyurl.com/DSM-5-CSSD

    More information on registration and preparing submissions here: http://tinyurl.com/DSM-5-register-to-comment

    For examples of last years submissions, go here: http://wp.me/PKrrB-AQ

    Copies of this years submissions are being collated here: http://wp.me/PKrrB-19a

    All stakeholders are permitted to submit comment and the views of patients, carers, families and advocates are important. But evidence-based submissions from the perspective of informed medical professionals clinicians, psychiatrists, researchers, allied health professionals, lawyers and other professional end users are likely to have more influence. All national and regional patient organizations need to submit comment.

    If you are a patient organization, professional, patient, carer or advocate and have already submitted and would like a copy of your comment added to my site, please send a copy to me.agenda@virgin.net
     
  6. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    Two journal articles mentioning CSSD: The Irish Psychologist; Australian Family Physician


    http://www.lenus.ie/hse/bitstream/10147/121822/1/SomatizationDis.pdf

    The Irish Psychologist

    Article

    February 2011


    Somatization Disorder:
    What Clinicians Need to Know

    Maeve Kenny and Jonathan Egan
    Mater Misericordiae University Hospital

    Volume 37, Issue 4, Page 93

    "Treatment

    "Clients with CSSD are typically over-utilisers of primary care services.
    The referring general practitioner will often express relief in the
    psychologist receiving the referral. These clients tend to hold strong
    beliefs about their illness, think catastrophically about their health,
    adopt a sick role and often present with anxiety and/or depression
    (Woolfolk & Allen, 2007). CSSD is commonly encountered in both primary and
    secondary care but despite its high incidence, the lack of appropriate care
    leads to increased hospital admissions and investigations. These
    investigations are often to the patient's detriment and they tend to double
    the cost to the health services compared to those without CSSD. Currently,
    psychiatric services tend to concentrate on "serious mental illness" or
    psychotic disorders, despite the large number of people suffering from
    somatoform disorders (Jorsh, 2006). Patients with CSSD run the risk of
    being overlooked by clinicians as they are neither medically "sick" nor do
    they have a "serious mental illness". Therefore, it is important to
    identify the issues in dealing with CSSD and create a clear plan for the
    sake of the patient, clinician, and cost to the health services."

    Full access in PDF

    ------------------------

    http://www.racgp.org.au/afp/201106/201106stone.pdf

    Reprinted from Australian Family Physician Vol. 40, No. 6, JUNE 2011

    Author


    Louise Stone MBBS, BA, MPH, DipRACOG, FRACGP, FACRRM, is a PhD candidate,
    Centre for Values, Ethics and the Law in Medicine, University of Sydney,
    New South Wales. louise.stone@gpet.com.au.

    Explaining the unexplainable

    Crafting explanatory frameworks for medically unexplained symptoms

    Full access in PDF

    ***********************************************************

    The closing date for comments in the second DSM-5 public review has been extended to July 15.

    Register to submit feedback via the DSM-5 Development website here:
    http://tinyurl.com/Somatic-Symptom-Disorders

    Once registered, log in with username and password and go to page: http://tinyurl.com/DSM-5-CSSD

    Copies of this year's submissions here: http://wp.me/PKrrB-19a
     
  7. SilverbladeTE

    SilverbladeTE Senior Member

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    Somewhere near Glasgow, Scotland
    [​IMG]

    sigh
     
  8. Nielk

    Nielk

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    Queens, NY
    "Patients with CSSD run the risk of
    being overlooked by clinicians as they are neither medically "sick" nor do
    they have a "serious mental illness". Therefore, it is important to
    identify the issues in dealing with CSSD and create a clear plan for the
    sake of the patient, clinician, and cost to the health services."

    What warped mind can come up with an idea like this? It's got to be someone who has a stake in the last few words (in bold).
    The fact that people can even come up with an idea like this is idiotic but that others are thinking about approving this is inhumane!

    ""for the sake of the patient" REALLY? in what way?:confused:
     
  9. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    From Suzy Chapman for http://dxrevisionwatch.wordpress.com

    24 June 2011


    Two part review from The New York Review of Books around psychiatry, the DSM and the rise in numbers being medicated for mental illness.


    Part One:

    http://www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/

    The Epidemic of Mental Illness: Why?

    June 23, 2011

    Marcia Angell

    The Emperor's New Drugs: Exploding the Antidepressant Myth
    by Irving Kirsch
    Basic Books, 226 pp., $15.99 (paper)

    Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America
    by Robert Whitaker
    Crown, 404 pp., $26.00

    Unhinged: The Trouble With Psychiatry-A Doctor's Revelations About a Profession in Crisis
    by Daniel Carlat
    Free Press, 256 pp., $25.00

    Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
    by American Psychiatric Association
    American Psychiatric Publishing, 992 pp., $135.00; $115.00 (paper)


    "It seems that Americans are in the midst of a raging epidemic of mental illness, at least as judged by the increase in the numbers treated for it. The tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007-from one in 184 Americans to one in seventy-six. For children, the rise is even more startling-a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children, well ahead of physical disabilities like cerebral palsy or Down syndrome, for which the federal programs were created.

    "A large survey of randomly selected adults, sponsored by the National Institute of Mental Health (NIMH) and conducted between 2001 and 2003, found that an astonishing 46 percent met criteria established by the American Psychiatric Association (APA) for having had at least one mental illness within four broad categories at some time in their lives. The categories were "anxiety disorders," including, among other subcategories, phobias and post-traumatic stress disorder (PTSD); "mood disorders," including major depression and bipolar disorders; "impulse-control disorders," including various behavioral problems and attention-deficit/hyperactivity disorder (ADHD); and "substance use disorders," including alcohol and drug abuse. Most met criteria for more than one diagnosis. Of a subgroup affected within the previous year, a third were under treatment-up from a fifth in a similar survey ten years earlier..."


    Part Two:

    http://www.nybooks.com/articles/archives/2011/jul/14/illusions-of-psychiatry/

    The Illusions of Psychiatry

    July 14, 2011

    Marcia Angell

    "...Not only did the DSM become the bible of psychiatry, but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions. That is an astonishing omission, because in all medical publications, whether journal articles or textbooks, statements of fact are supposed to be supported by citations of published scientific studies. (There are four separate "sourcebooks" for the current edition of the DSM that present the rationale for some decisions, along with references, but that is not the same thing as specific references.) It may be of much interest for a group of experts to get together and offer their opinions, but unless these opinions can be buttressed by evidence, they do not warrant the extraordinary deference shown to the DSM. The DSM-III was supplanted by the DSM-III-R in 1987, the DSM-IV in 1994, and the current version, the DSM-IV-TR (text revised) in 2000, which contains 365 diagnoses..."

    "...The drug industry, of course, supports other specialists and professional societies, too, but Carlat asks, "Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?" His answer: "Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another." Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness-no lab data or MRI findings-and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that..."


    ***********************************************************

    The closing date for comments in the second DSM-5 public review has been extended to July 15.

    Register to submit feedback via the DSM-5 Development website here:
    http://tinyurl.com/Somatic-Symptom-Disorders

    Once registered, log in with username and password and go to page:
    http://tinyurl.com/DSM-5-CSSD

    Copies of this year's submissions are being collated here:
    http://wp.me/PKrrB-19a


    ***********************************************************

    Suzy Chapman
    _____________________

    me.agenda@virgin.net
    http://dxrevisionwatch.wordpress.com
    http://meagenda.wordpress.com
    http://www.facebook.com/MEagenda
    http://twitter.com/MEagenda
     
  10. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    http://www.texastribune.org/texas-s...exas-rule-will-prescribe-fewer-drugs-to-kids/

    Texas Rule Will Prescribe Fewer Potent Drugs to Kids

    by Emily Ramshaw
    6/22/2011

    "Children on Medicaid under the age of three would not be prescribed powerful anti-psychotic drugs without a special authorization, under new rules the state Health and Human Services Commission (HHSC) implemented last week.

    In response to widespread concerns about the number of impoverished Texas kids being prescribed drugs like Seroquel and Risperdal medications that can have serious side effects in children prescribing doctors would have to get a prior authorization from the state, a steep hurdle designed to limit use of the drugs.

    The changes to state policy, which took effect June 14, are based on evidence-based clinical criteria and nationally recognized peer-reviewed information, said Stephanie Goodman, a spokeswoman for the HHSC...

    "...The goal is not to micromanage, or to delay needed treatment, Turner said at the time. But there should be at least some minimum level of authorization to check the safety and appropriateness of these drugs in children under 16."
     
  11. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    [​IMG]

    [​IMG]


    A reminder that there are still 13 days left in which to submit letters of concern to the APA in the second public review of draft criteria


    • If you haven't already submitted a letter, this year, and if you are up to it, I urge you to register and submit feedback before the closing date on July 15.

    • If you know an informed clinician, social worker, educator, lawyer, politician who might be persuaded to submit a response as a professional stakeholder please approach them for a submission.

    • If the name of your national, regional, state patient organization isn't listed below, please contact them, this week, and ask them to review the proposals and submit a response.

    I am collating submissions to DSM-5 on my website. If you have already submitted and would like a copy of your submission included with the others on my site, please forward a copy to me via PM or to me.agenda@virgin.net stating how you would like to be styled. No email addresses will be published.

    If you are aware of a patient org that has submitted but is not yet included in the list below, or a professional who might be prepared to release a copy of their submission for publication on my site, I'd be pleased if you could let me know.

    http://wp.me/PKrrB-19a

    Published submissions collated on DSM-5 and ICD-11 site:

    Page 1: International patient organizations

    Coalition4ME/CFS (US); CFIDS; Rocky Mountain CFS/ME and FM Association; National ME/FM Action Network (Canada); The Danish ME Association; ESME; EMEA; The ME Association UK); Action for M.E.; IACFS/ME (US); ME Free For All.org (UK); The Young ME Sufferers Trust (UK)

    Page 2: Medical, allied health and other professional stakeholders

    Richard A. Van Konynenburg, Ph.D. (US); Therese Duncan J.D., CADCII, ICADC (US); Angela Kennedy, sociology lecturer (UK); Dr John L Whiting MD, (Australia)

    Page 3: Patients and advocates

    B Tilley (UK); Suzy Chapman (UK); Glen Rich (Canada); Maarten Maartensz (NL); US patient 1; Jay Spero (US); UK patient 2; 26yearsME/CFS; UK patient 1; Gabrielle Lewis (UK); Chris Douglas (UK); Kati (Canada); Kevin Short (UK); Susanna Agardy (Australia); Mary Barker (US); Peter Kemp (UK); Mary M. Schweitzer (US)

    Page 4: Professional bodies

    British Psychological Society (BPS)

    ---------

    The closing date for comments in the second DSM-5 public review is extended to July 15.

    Register to submit feedback via the DSM-5 Development website here: http://tinyurl.com/Somatic-Symptom-Disorders

    Once registered and logged in, leave comment on the CSSD criteria here: http://tinyurl.com/DSM-5-CSSD

    More information on registration and preparing submissions here: http://tinyurl.com/DSM-5-register-to-comment

    Copies of this years submissions including the Coalition4ME's "Call to Action" resources, collated here: http://wp.me/PKrrB-19a

    [​IMG]

    [​IMG]

    [​IMG]

    [​IMG]

    Images Copyright ME agenda 2011 No unauthorized reproduction.
     
  12. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    In June, the British Psychological Society submitted a response to the DSM-5 draft proposals.

    The section of their submission which specifically addressed the current proposals for "Somatic Symptoms Disorders" is published on my site on Page 4 of the collated responses for this second stakeholder review exercise, here:

    http://dxrevisionwatch.wordpress.com/dsm-5-proposals/dsm-5-submissions-2011/4/


    Dr Darrel Regier, Vice-Chair of the DSM-5 Task Force, has replied to the response of the British Psychological Society.

    Full text of commentary in response to Dr Regier's reply on behalf of the DSM-5 Task Force can be read here:

    http://www.thepsychologist.org.uk/blog/11/blogpost.cfm?threadid=2102&catid=48

    The Psychologist News - Society's critical response to DSM-5

    July 13, 2011

    Society's critical response to DSM-5


    ----------------------

    http://tinyurl.com/6czj3sj

    On The Implications Of Changing Constructs Of Pain And Addiction Disorders In The DSM-5: Language Games, Ethics, And Action

    James Giordano PhD
    Director
    Center for Neurotechnology Studies
    Potomac Institute for Policy Studies
    Arlington VA USA


    Citation: J. Giordano : On The Implications Of Changing Constructs Of Pain And Addiction Disorders In The DSM-5: Language Games, Ethics, And Action. The Internet Journal of Law, Healthcare and Ethics. 2011 Volume 7 Number 1


    "To be sure, the DSM-5 may offer an opportunity to better characterize pain, and in this way might fulfill the role of diagnosis in framing the disorder and determining the type and extent of care required. For example, an Axis I diagnosis of chronic pain as a presentation of CSSD, when coupled to an Axis III general medical condition (such as fibromyalgia) and Axis IV psychosocial stressors would certainly depict pain as a complex, multi-dimensional and multi-symptomatic disorder. However, while the changes proposed for DSM-5 are intended to clarify diagnosis of pain syndromes, I wonder whether the medical field and its administrative and economic infrastructures (e.g.- insurance providers, etc) are prepared for such change(s). Without a preemptive or at least concomitant shift in the current climate and conduct of pain care to recognize the profoundly interactive physiological and psychological dimensions and presentations of pain (and the pain patient), I fear that the nomenclature and descriptions used to define pain disorders in the DSM-5 might create ambiguity concerning 1) the reality of pain; 2) the need for both physiological and psychological care, 3) the type (and exigencies) of pharmacotherapeutics required, and 4) the disposition of economic resources necessary to sustain such approaches."

    -------------------

    Three days left before the second DSM-5 stakeholder review period closes


    On June 16, the American Psychiatric Association (APA) announced an extension to its second public stakeholder review of draft proposals for categories and criteria for the next edition of the Diagnostic and Statistical Manual of Mental Disorders, which will be known as DSM-5?.

    The closing date for submissions is now Friday, July 15.

    There are just three more days left in which to submit letters of concern in response to the potentially damaging proposals being put forward by the Work Group for Somatic Symptom Disorders the DSM-5 committee charged with the revision of existing DSM-IV Somatoform Disorders categories.

    If you havent already submitted a comment, please do, however brief. Youll find information on making submissions in this post: http://tinyurl.com/DSM-5-register-to-comment.

    Proposed criteria and two key documents are posted here: http://wp.me/pKrrB-13z.

    For examples of letters of concern, copies of this years submissions, including the Coalition4ME/CFSs resource materials and template letter, collated here: http://wp.me/PKrrB-19a.

    These include letters from international patient organizations, professional stakeholders, patients, patient advocates and professional bodies.

    If you have already submitted but have other points to make, please submit a second response.

    If you know an informed professional please alert them today to the implications for patients with ME, CFS, IBS, FM, CI, CS, Gulf War illness and other illnesses that are bundled under the Functional Somatic Syndromes and Medically Unexplained umbrellas and ask if they can get a response in.

    If the Work Groups current proposals are approved, patients with these illnesses will be sitting ducks for an additional mental health diagnosis of a Somatic Symptom Disorder bolted on to a general medical conditon, or for misdiagnosis with CSSD or SSSD.

    If you havent yet registered your concerns, please get a letter in before the feedback period closes on July 15!


    Register to submit feedback via the DSM-5 Development website here: http://tinyurl.com/Somatic-Symptom-Disorders

    Once registered, log in with username and password and go to page: http://tinyurl.com/DSM-5-CSSD

    Copies of this years submissions are being collated here: http://wp.me/PKrrB-19a
     
  13. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

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    New book: Medically Unexplained Symptoms, Somatisation and Bodily Distress

    New book published by the Bodily Distress bunch

    From Suzy Chapman for http://dxrevisionwatch.wordpress.com

    18 July 2011

    Note: Four members of the DSM-5 "Somatic Symptom Disorders" Work Group are contributors to this new book, published in July: Arthur Barsky, Francis Creed, Sing Lee and Michael Sharpe.

    The book appears to have developed out of the White Paper by the "MUS" study group of the European Association for Consultation-Liaison Psychiatry and Psychosomatics 1], on which I have previously reported and meetings held in Manchester in May 2009 [2] and Munich in September 2009 [3]:


    Published by Cambridge University Press, 14 July 2011

    Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services

    Creed, Francis; Henningsen, Peter; Fink, Per

    Product details

    Hardcover: 288 pages
    Publisher: Cambridge University Press (14 July 2011)
    Language English
    ISBN-10: 0521762235
    ISBN-13: 978-0521762236

    RRP: 55

    Product Description

    Medically unexplained symptoms and somatisation are the fifth most common
    reason for visits to doctors in the USA, and form one of the most expensive
    diagnostic categories in Europe. The range of disorders involved includes
    irritable bowel syndrome, chronic widespread pain and chronic fatigue
    syndrome. This book reviews the current literature, clarifies and
    disseminates clear information about the size and scope of the problem, and
    discusses current and future national and international guidelines. It also
    identifies barriers to progress and makes evidence-based recommendations
    for the management of medically unexplained symptoms and somatisation.
    Written and edited by leading experts in the field, this authoritative text
    defines international best practice and is an important resource for
    psychiatrists, clinical psychologists, primary care doctors and those
    responsible for establishing health policy.

    About the Author

    Francis Creed is Professor of Psychological Medicine, School of
    Community-Based Medicine, University of Manchester, Manchester, UK.

    Peter Henningsen is Professor of Psychosomatic Medicine, Technical
    University Munich, Munich, Germany.

    Per Fink is Professor of Functional Disorders, The Research Clinic for
    Functional Disorders and Psychosomatics, Aarhus University Hospital,
    Aarhus, Denmark.

    --------

    Some pages of this book can be read on Google Books at:

    http://books.google.com/books?id=UQjdZrkyWkoC&pg=PA1#v=onepage&q&f=false


    Contents

    1. Epidemiology: prevalence, causes and consequences Francis Creed, Arthur
    Barsky and Kari Ann Leiknes;

    2. Terminology, classification and concepts Peter Henningsen, Per Fink,
    Constanze Hausteiner-Wiehle and Winfried Rief;

    3. Evidence-based treatment Francis Creed, Kurt Kroenke, Peter Henningsen,
    Alka Gudi and Peter White;

    4. Current state of management and organisation of care Per Fink, Chris
    Burton, Jef de Bie, Wolfgang Sllner and Kurt Fritzsche;

    5. Barriers to improving treatment Peter Henningsen, Christian Fazekas and
    Michael Sharpe;

    6. Gender, lifespan and cultural aspects Constanze Hausteiner-Wiehle,
    Gudrun Schneider, Sing Lee, Athula Sumipathala and Francis Creed;

    7. Medically unexplained symptoms in children and adolescents Emma
    Weisblatt, Peter Hindley and Charlotte Rask;

    8. Identification, assessment and treatment of individual patients Francis
    Creed, Christina van der Feltz, Else Guthrie, Peter Henningsen, Winfried
    Rief, Andreas Schrder and Peter White;

    9. Training Per Fink, Kurt Fritzsche, Wolfgang Sllner and Astrid Larisch;

    10. Achieving optimal treatment organisation in different countries -
    suggestions for service development applicable across different healthcare
    systems
    Francis Creed, Peter Henningsen and Richard Byng; Index

    Contributors

    Francis Creed, Arthur Barsky, Kari Ann Leiknes, Peter Henningsen, Per Fink,
    Constanze Hausteiner-Wiehle, Winfried Rief, Kurt Kroenke, Alka Gudi, Peter
    White, Chris Burton, Jef de Bie, Wolfgang Sllner, Kurt Fritzsche,
    Christian Fazekas, Michael Sharpe, Gudrun Schneider, Sing Lee, Athula
    Sumipathala, Emma Weisblatt, Peter Hindley, Charlotte Rask, Christina van
    der Feltz, Else Guthrie, Andreas Schrder, Peter White, Astrid Larisch,
    Richard Byng

    --------

    Preface available to view

    Chapter One: Epidemiology: prevalance, causes and consequences Frances Creed, Arthur Barsky and Kari Ann Leiknes

    Pages 1, 2, 5, 6, 9-12, 14, 16-19, 21, 35-38, 42 available to view.

    Chapter Two: Terminology, classification and concepts Peter Henningsen, Per Fink, Constanze Hausteiner-Wiehle and Winifried Rief

    Pages 43-46, 49 available to view.

    Pages 50 to 258 of this book are not available to view.


    "They [unexplained bodily symptoms] form one of the most expensive categories of health care expenditure in Europe. This book makes the case for shifting some of this expenditure away from numerous investigations for organic disease and towards effective treatment of bodily distress." (Preface vi)

    "Since the traditional labels 'medically unexplained symptoms' or 'somatisation' are so unhelpful, we propose the term 'bodily distress' as a more useful term for these disorders..." (Preface vi)

    "ICD-10 included neurasthenia (chronic fatigue), as one of the somatoform disorders. This is considered here as chronic fatigue syndrome under the heading of functional somatic syndromes." (Page 8)

    Some discussion of functional somatic syndromes on Page 10-16.

    DSM-5 proposals for "CSSD" discussed briefly on Pages 43-45 with discussion of alternative terms (bodily distress disorder, functional somatic disorder/syndrome).

    Current classification of "Somatoform Disorders" in DSM-IV and ICD-10 discussed on Page 46.

    --------------

    References and related material:

    [1] Patients with medically unexplained symptoms and somatisation - a challenge for European health care systems: A white paper of the EACLPP Medically Unexplained Symptoms study group by Peter Henningsen and Francis Creed: http://www.eaclpp.org/working_groups.html
    http://www.eaclpp.org/documents/Patientswithmedicallyunexplainedsymptomsandsomatisation_000.doc


    [2] Is there a better term than "Medically unexplained symptoms"? Creed F, Guthrie E, Fink P, Henningsen P, Rief W, Sharpe M and White P (Journal of Psychosom Research: Volume 68, Issue 1, Pages 5-8 January 2010) discusses the deliberations of the EACLPP MUS study group. The Editorial also includes references to the DSM and ICD revision processes.
    http://www.ncbi.nlm.nih.gov/pubmed/20004295


    [3] European Science Foundation: Setting Science Agendas for Europe

    Exploratory Workshop Scheme, Standing Committee for the European Medical Research Councils (EMRC)

    ESF Exploratory Workshop on "Understanding the genetic, physiological and psychological mechanisms underlying disabling medically unexplained symptoms and somatisation", Munich, 10-12 September 2009

    Report on September 2009 European Science Foundation workshop


    [4] "One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders." Psychosom Res. 2010 May;68(5):415-26. Fink P, Schrder A. The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8000 Aarhus, Denmark.
    http://www.ncbi.nlm.nih.gov/pubmed/20403500


    [5] EURASMUS
    The multidisciplinary European Research Association for Somatisation and Medically Unexplained Symptoms (EURASMUS) was formed to study the genetic, psychological and physiological mechanisms underlying bodily distress. Co-convenors: Francis Creed, Peter Henningsen
    http://eurasmus.net/



    Suzy Chapman
    _____________________

    me.agenda@virgin.net
    http://dxrevisionwatch.wordpress.com
    http://meagenda.wordpress.com
    http://www.facebook.com/MEagenda
    http://twitter.com/MEagenda
     
  14. SilverbladeTE

    SilverbladeTE Senior Member

    Messages:
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    Somewhere near Glasgow, Scotland
    Well, since Irritable Bowel Syndrome has been PROVEN to exist and have a treatable cause, they are *QUACKS*: fakes, snake oil salesmen, and should be taken to court for it.

    http://gut.bmj.com/content/59/9/1213.abstract

     
  15. max

    max *****

    Messages:
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    this at the Daily Mail site.

    ...... "Some have been misdiagnosed as having a psychiatric illness for 20 years or more and been treated with antidepressants, mood-stabilising drugs, mental hospital in-patient treatment and electro-convulsive therapy.

    Read more: http://www.dailymail.co.uk/health/a...eally-crippled-period-pain.html#ixzz1Sb83QNlb

    Sound familiar?
    Psycs are everywhere - if they are not stopped soon, they will not be stopped.
    Psychiatry is a virus - how ironic is that?

    max
     
  16. justinreilly

    justinreilly Stop the IoM & P2P! Adopt CCC!

    Messages:
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    NYC (& RI)
    Professor Stud is Prof. Hooper, correct? ;) He's going to rescue everyone from the psychiatrists! :D
     
  17. justinreilly

    justinreilly Stop the IoM & P2P! Adopt CCC!

    Messages:
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    NYC (& RI)
    Thanks for alerting us of this new ridiculous book. We already knew what they have been trying to do with their 'bodily distress' and 'somatic symptoms disorders', but this really lays it bare!

    Good quotes you pointed out. I found this one interesting:

    Glad Drs. Creed and Fink (you can't make these names up!) are looking out for the patients by blocking "investigations for possible organic disease" both at the clinical and research levels!
     
  18. Nielk

    Nielk

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    Queens, NY
    Do Psychiatrists not take the Hippocratic Oath?

    "I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone"

    I say that their licenses should be taken away for all the abuse they have perpetrated on us.
    Because of them, important studies and treatments have been withdrawn for us.
    In addition, all the stressful abuse has been having a direct effect ofnthe deterioration of our illness.
     
  19. Dx Revision Watch

    Dx Revision Watch dxrevisionwatch.com

    Messages:
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    UK
    Second DSM-5 stakeholder review period closes

    The second DSM-5 stakeholder review period is now closed

    Well, that's it until the third stakeholder review which is currently scheduled for January-February 2012, for two months, according to the most recent DSM-5 Timeline.

    The APA posted the following on the DSM-5 Development site on July 15 (though the comment period was extended to midnight July 18 for email responses):

    http://www.dsm5.org/Pages/Default.aspx

    The 2nd period for submitting comments and suggestions to the web site regarding the proposed diagnostic criteria revisions, and the newly proposed organizational structure for DSM-5 took place from May 4th-July 15th. We are appreciative of your ongoing interest in contributing to this process. During our first comment period, we received over 8600 comments from you, our viewers. We encourage you to spend time on this site to investigate the myriad ways your comments helped shape some of the recent updates to the proposed diagnostic criteria. During the second comment period, we received over 2000 comments and our work groups are actively reviewing your input. Thank you for taking the time to provide your insights, experiences, and expertise toward these important issues.



    As I've said in one of the other DSM-5 threads, the fact that the number of responses was well down on last year's initial review exercise was likely a major factor in the APA's decision to extend the comment period by an additional four weeks.


    What happens now?

    Shortly after the closure of last year's stakeholder review, in April 2010, the APA issued a news release. If a news release is issued in response to the closure of this second comment period, I will post a copy in this thread, which is the original DSM-5 thread.

    I shall continue to monitor the DSM-5 Development site for any changes to the Timeline and any revisions to the current proposals for the "Somatic Symptom Disorders" categories and checking for edits to the two key documents:

    http://tinyurl.com/Somatic-Symptom-Disorders

    PDF: http://tinyurl.com/SSD-Disorders-Description

    PDF: http://tinyurl.com/SSD-Justification-of-Criteria

    The various sections of DSM may be subject to revision between the two phases of the field trials, which take place this summer and fall. So there may be interim revisions to the "Somatic Symptom Disorders" proposals before the third stakeholder review is announced and a third draft posted, early next year.


    These radical proposals for the reorganization of the "Somatoform Disorders" categories are at odds with the corresponding section of Chapter 5 of the forthcoming ICD-10-CM, which remain broadly similar to the categories and codings in the international version of ICD-10 (note that in ICD-10, Neurasthenia is coded at F48.0, but coded at F48.8 in ICD-10-CM). The partial code freeze for ICD-10-CM codings will be implemented on October 1, 2011.


    ICD-10-CM

    http://www.cdc.gov/nchs/icd/icd10cm.htm#10update

    ICD-10-CM TABULAR LIST of DISEASES and INJURIES

    Chapter 5
    Mental and behavioural disorders

    F45

    Somatoform disorders
    Excludes2:
    dissociative and conversion disorders (F44.-)
    factitious disorders (F68.1-)
    hair-plucking (F63.3)
    lalling (F80.0)
    lisping (F80.0)
    malingering [conscious simulation] (Z76.5)
    nail-biting (F98.8)
    psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54)
    sexual dysfunction, not due to a substance or known physiological condition (F52.-)
    thumb-sucking (F98.8)
    tic disorders (in childhood and adolescence) (F95.-)
    Tourette's syndrome (F95.2)
    trichotillomania (F63.3)

    F45.0
    Somatization disorder
    Briquet's disorder
    Multiple psychosomatic disorder

    F45.1
    Undifferentiated somatoform disorder
    Undifferentiated psychosomatic disorder

    F45.2
    Hypochondriacal disorders
    Excludes2:
    delusional dysmorphophobia (F22)
    fixed delusions about bodily functions or shape (F22)

    F45.20
    Hypochondriacal disorder, unspecified

    F45.21
    Hypochondriasis
    Hypochondriacal neurosis

    F45.22
    Body dysmorphic disorder
    Dysmorphophobia (nondelusional)
    Nosophobia

    F45.29
    Other hypochondriacal disorders

    F45.4
    Pain disorders related to psychological factors
    Excludes1:
    pain NOS (R52)

    F45.41
    Pain disorder exclusively related to psychological factors
    Somatoform pain disorder (persistent)

    F45.42
    Pain disorder with related psychological factors
    Code also associated acute or chronic pain (G89.-)

    F45.8
    Other somatoform disorders
    Psychogenic dysmenorrhea
    Psychogenic dysphagia, including 'globus hystericus'
    Psychogenic pruritus
    Psychogenic torticollis
    Somatoform autonomic dysfunction
    Teeth grinding
    Excludes1:
    sleep related teeth grinding (G47.63)

    F45.9
    Somatoform disorder, unspecified
    Psychosomatic disorder NOS

    F48
    Other nonpsychotic mental disorders

    F48.1
    Depersonalization-derealization syndrome

    F48.8
    Other specified nonpsychotic mental disorders
    Dhat syndrome
    Neurasthenia
    Occupational neurosis, including writer's cramp
    Psychasthenia
    Psychasthenic neurosis
    Psychogenic syncope

    F48.9
    Nonpsychotic mental disorder, unspecified
    Neurosis NOS

    ---------

    For comparison with the ICD-10 Chapter IV codes for "Somatorm Disorders", the online Tabular List for 2007 is here. (There is supposed to be an ICD-10 online Tabular List for 2010 which incorporates all the yearly updates to ICD-10 since 2007, published on the WHO site, this year.)

    http://www.who.int/classifications/apps/icd/icd10online/?gf40.htm f480

    ----------

    This simplified table below sets out how DSM-IV and international ICD-10 currently correspond for "Somatoform Disorders"

    Current DSM-IV Codes and Categories for Somatoform Disorders and ICD-10 Equivalents

    [​IMG]


    There is also a comparison which includes criteria on Page 6 of the new book

    Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services. Creed, Francis; Henningsen, Peter; Fink, Per

    http://books.google.com/books?id=UQjdZrkyWkoC&pg=PA6#v=onepage&q&f=false

    ----------

    From the ICD-11 Alpha Browser at July 19:

    ICD-11 Alpha Browser

    http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_F40-F48

    Chapter 5

    05E Neurotic, stress-related and somatoform disorders

    [...]

    05E05 Somatoform disorders
    05E05.00 Somatization disorder
    05E05.01 Undifferentiated somatoform disorder
    05E05.02 Hypochondriacal disorder
    05E05.03 Somatoform autonomic dysfunction
    05E05.04 Persistent somatoform pain disorder​
    05E05.04.00 Persistent somatoform pain disorder
    05E05.04.01 Chronic pain disorder with somatic and psychological factors​
    05E05.05 Other somatoform disorders
    05E05.06 Somatoform disorder, unspecified​

    05E06 Other neurotic disorders
    05E06.00 Neurasthenia
    05E06.01 Depersonalization-derealization syndrome
    05E06.02 Other specified neurotic disorders
    05E06.03 Neurotic disorder, unspecified​

    --------

    Note that new codes have been assigned to ICD-11 categories throughout all chapters of ICD-11. It's not known yet what eventual codes will be assigned for categories in the various chapters. For example, Chronic fatigue syndrome is currently proposed to be coded in Chapter 6 at 06L00, see

    http://dxrevisionwatch.files.wordpress.com/2011/05/icd-alpha1-17-05.png

    and

    http://dxrevisionwatch.files.wordpress.com/2011/05/icd-alpha4-19-05-11.png

    In July, ICD-11 is anticipated to open up the ICD-11 Alpha Browser for comment to interested, registered stakeholders.

    Suzy Chapman
     

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