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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. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    Change what, teejkay?

    The fact that none of the UK patient orgs are currently talking about DSM and ICD revisions to their members or the fact that the ME Association has recently taken on a psychology adviser?

    The ME Association is run by a small Board of Trustees. The organisation has had no CEO or Acting CEO since early 2004.

    Bringing about change within the ME Association is very difficult since the Board of Trustees gave itself the power, several years ago, to control whose names go forward onto Trustee election ballot papers and whose names do not.

    It is therefore very difficult to effect change at Board level.

    Dr Charles Shepherd, Trustee and Honorary Medical Adviser issued a rationale for this decision, which I will try and dig out for you later today.

    Dr Goudsmit, who is a patient herself, participates in discussions on the ME Association's Facebook Wall.

    When Dr Goudsmit responds to comments from users of the MEA's Facebook Wall, it is unclear when Dr Goudsmit is responding in a purely personal capacity, when she is responding as "Psychology Adviser" to the MEA and therefore speaking for and on behalf of the MEA, or speaking on behalf of individuals connected with the MEA, to take a recent example, on behalf of Dr Charles Shepherd.

    I am always very uncomfortable when representatives of patient organisations and their satellites start participating in internet forums and platforms where these distinctions are blurred.

    For example, if one objects to the tone of a response or to a position set out via a response, one needs to be clear about the basis on which that response has been made.

    A few years ago, several members of the ME Association involved themselves in discussions on internet message boards (which included discussions around organisation policy) without these distinctions being drawn up. This resulted in mayhem.

    Declaration of interest: I have been denied membership of the ME Association by the Board of Trustees.

    Suzy
  2. flybro

    flybro Senior Member

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    Hi Suzy,

    This is my third attempt at a reply.
    Lost the last two after 20 mins each. Gutted.

    So all your getting now is this.

    You come across as factual, urgent, educated and informed, not hair splitting.

    What I wanted to know is there anything any of us as individuals can do, or should do.

    Is there a battle we should be prepearing for, and if there is how should we prepare. Or is it too late.

    The other two were far better. :rolleyes:


    Cheers
  3. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    Hi flybro,

    I'm sorry you lost your posts.

    I've vowed to write all long posts as a draft email, first, then paste and format. I've lost so many posts on this site. Two or three days ago I was on the point of clicking the "Submit Reply" button for a long response to fresh_eyes on the other DSM, ICD thread, when up popped Cort's alert to say that the site was now down for maintenance and I lost three quarters of an hour of composing. I could have wept. So now, unless it's just a few lines, I am putting my postings together where I can save a copy before uploading.

    I am weary tonight and will respond in the next day or two.

    Maybe these little chaps will cheer you up - you'll need your mouse.

    http://www.nobodyhere.com/toren.hier

    Suzy
  4. starryeyes

    starryeyes Senior Member

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    Hi ME Agenda,

    Thank you for your patience. You're dealing with very brainfogged people here. lol Not to mention, forum problems.

    Flybro, you may want to try typing replies in Open Office which is free to Download first. Then you have it if the forum loses it and/or copy your text as you go along. I know how frustrating that is.

    ETA: Sorry you lost yours too me agenda. That's the worst!

    Yes. Both.

    I'm sorry the ME Association won't let you be a member. Are they shills for Wessely? It sure sounds like it.

    My question is the same as Flybro's. Can you spell out for us what steps we can take to help with this situation?
  5. Min

    Min Senior Member

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    At least the MEA has members, who have voting right and AGMs

    - the people that the charity Action for ME refer to as members are only subscribers to the magazine in law and have no voting rights and no AGMs. The only members in law are the executive, who fully support the NICE guidelines that permit us only psychological treatments, and who fully support the taxpyer funded 2.7 million PACE & NICE trials run by Sharpe, Chalder, White etc & overseen by Wessely.
  6. flybro

    flybro Senior Member

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    Cheers Suzy, and teej,

    Stupid thing is I had notepad open both times, with that very idea in mind.

    I forgot to use it.

    In the lasrt few months I feel like I've been on a crash course covering, history, politics, biology, virology and forumology, all while learning the language of ME/CFS.

    Suzy I think you'll find quite a few of us are impressed with your site, the vast amount of archiving you've done, and the fact that you actually understand the details and the big picture.

    You've got my vote of confidence, which means, when I don't know stuff, your'll be the one I'll be asking.
  7. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    Hi teejkay

    I'll respond to your request, tomorrow. In the meantime:

    Here in the UK, we are expecting the publication of the MRC funded PACE and FINE Trials this coming spring. We also have the NICE Guideline for CFS/ME due for review from August, this year. The results of PACE and FINE can be pretty much predicted and are likely to influence the types of treatments offered by NHS CFS and CF Clinics for many years to come. The results of PACE and FINE will also inform the review of the NICE Guideline.

    I haven't found the posting I wanted to quote from, but one of the reasons put forward for the taking on of a psychology adviser, was, apparently, in order that the ME Association might be better equipped to respond to the findings of the PACE and FINE Trials.

    If Dr Goudsmit wishes to set out her stall, then she is free to become a member of Cort's forums and do so but I will not be prepared to repost here any of her mailings sent out via Co-Cure, either in relation to PACE/FINE or any other issue which she has written about, or may write about in the future.

    Co-Cure is an international mailing list which maintains a public archive for mailings. Dr Goudsmit submits material to Co-Cure and also responds to issues raised on Co-Cure by others (though strictly speaking it is not a discussion list). Dr Goudsmit's Co-Cure mailings have a "sig" at the foot which states that her emails and attachments are confidential and solely for the information of the addressee and that any copying or disclosure to a third party is unauthorised. Therefore, although Co-Cure maintains a public archive, recipients of her Co-Cure postings via the mailing list are faced with uncertainty as to whether Dr Goudsmit intends that her Co-Cure mailings may be republished or not.

    Dr Goudsmit has also requested that her comments on the ME Association's Facebook site (on the pages of which she has been quite active of late) must not be reposted elsewhere. So this means that if I want to refer to any postings by Dr Goudsmit that it will be necessary for me to give the URL for the postings and not publish them here.

    Dr Goudsmit has sought to discourage me from raising awareness of the DSM and ICD-10 revision processes and other material, on several occasions, when I have put material out on Co-Cure.

    You can read Dr Goudsmit's comments here:

    Mon, 25 May 2009 ACT: CFS and somatoform disorders
    http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0905d&L=co-cure&T=0&F=&S=&P=2936

    Then her correction:

    Tue, 26 May 2009 Re: ACT: CFS and somatoform disorders
    http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0905d&L=co-cure&T=0&F=&S=&P=3544


    Mon, 5 Oct 2009 ACT: Distractions
    http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0910a&L=co-cure&T=0&F=&S=&P=3047


    Then her "Right of Reply" in response to my concerns that she was seeking to limit discussion of DSM and ICD issues.

    Tue, 6 Oct 2009 ACT: right of reply
    http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0910a&L=co-cure&T=0&F=&S=&P=3918
  8. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    http://www.timesonline.co.uk/tol/life_and_style/health/features/article6998742.ece

    January 25, 2010

    ‘Doctors, school, friends thought I was faking chronic fatigue syndrome’
    As the trial of Kay Gilderdale puts ME back in the spotlight, we ask why more is not being done to help sufferers


    Big article in UK Times today in Times2 section

    page two sits along Dr Mark Porter piece on euthanasia and recent Inglis legal case.
  9. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    Hi teejkay and flybro

    I will endeavour to keep this response simple but I'm afraid I cannot keep it short.

    I contacted Prof Creed yesterday. I asked whether there was a transcript, summary or notes for the lengthy slide presentation he gave at the November meeting of The Academy of Psychosomatic Medicine. Prof Creed says that he is intending to write up a summary and will send me a copy when he has done so. I hope that he will, but it may not be for some time.

    I have tried to set out material on my new site as simply as possible. I still have all the CISSD Project material to sift through and add pages for.

    My new site:

    The URL for my new Dx Revision Watch site is: http://dxrevisionwatch.wordpress.com

    I have set out what we know so far about DSM Somatic Symptom Disorders Work Group proposals on this page:
    DSM-5 proposals Sub page 1: http://wp.me/PKrrB-hT

    I have set out the codings for PVFS, ME and Chronic fatigue syndrome in ICD-10 on this page:
    http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/

    Other pages have background to the DSM revision process and the ICD-10 revision.

    At the end of Page 2 of this page: http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/

    I have given links for the current proposals for the US "Clinical Modification" US-ICD-CM which is due for implementation in October 2013.

    Be aware that there will be some in the US (and elsewhere) who prefer that CFS is separated from ME in ICD codings.


    As I've set out to fresh_eyes, it is not possible for me to make an informed opinion about the WHO's intentions and I have made no claims about ICD-11.

    (In this posting on the original DSM thread at: http://forums.aboutmecfs.org/showthread.php?1675-APA-moves-DSM-5-Publication-date-to-2013/page4 Post # 34)

    We currently have no indication about any proposals that ICD-11 Revision might be proposing for either Chapter V or Chapter VI of ICD-10 from any ICD Topic Advisory Group Summary Reports and we have no draft yet for ICD-11.

    As far as the revision of ICD-10 goes, it is too early to establish what, if any, changes ICD Revision might be proposing for the three terms of relevance to us.

    I am not therefore prepared to make any predictions or assumptions about proposals for ICD-11 and I have made no predictions or assumptions in any of the material that I have published in the last 11 months, either on my sites or elsewhere about ICD-11.

    So if you see anywhere on the internet that "ME agenda" says WHO want to do such and such for ICD-11..." I am being misreported. Please send me the URLs so that I can correct any misreportings.

    Make sure people have solid, documented information (or sources for this) - not speculation.

    For the US, the 2013 Clinical Modification has more immediate relevance - although the structure of ICD-11 (and that of DSM-V) may have some influence on ICD-10-CM before it is "frozen".


    Clinical Modifications:


    What you want to avoid is getting into a tangle between ICD-10, ICD-11 and ICD-10-CM.

    Remember also that the commitment to striving, as far as possible, for congruency between the two systems is a joint undertaking between the APA and WHO, although WHO acknowledge that there will be areas where it won't be possible to achieve this.

    When you are discussing DSM and ICD and codings with others, the first thing you will need to ensure is that they understand that not all countries are currently using ICD-10. They will need to refer to their own Clinical Modification for codings for PVFS, ME or (Benign) ME, and Chronic fatigue syndrome.

    By all means refer them to this page: http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/ if they want information on current ICD-10 codings.

    I will be adding an additional page with links for the various national modifications later this week.

    If you are not already confident about the current proposals for the US CM for October 2013, the URLs are here:

    Current proposals for the US Clinical Modification ICD-10-CM, scheduled for implementation in October 2013, propose classifying Chronic fatigue syndrome at R53.82.

    Wikipedia: http://en.wikipedia.org/wiki/History_of_chronic_fatigue_syndrome#ICD-10-CM

    For most recent ICD-10-CM proposals see:


    CDC site: International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

    http://www.cdc.gov/nchs/icd/icd10cm.htm

    The 2010 update of ICD-10-CM is now available and replaces the July 2009 version:

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

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

    What should you do?


    It depends on how much energy, time and concern you have.

    I am UK, as is flybro.

    Your perspective of DSM differs from ours in at least three important areas:

    1] DSM does not have the same relevance in the UK as it does for the US. We tend to use Chapter V of ICD-10, here. What goes into DSM-V will have a downstream effect on us - literature, research, the conference and symposia circuit. So we in the UK (and Europe and other parts of the globe) are stakeholders in the development of DSM.

    2] In the UK we are looking towards ICD-11. In the US you are looking towards implementation of ICD-10-CM - with a different proposed coding for Chronic fatigue syndrome than in ICD-10 (or in ICD-10-CA, the Canadian modification, which has all three terms at G93.3).

    3] In the US, your health care system and welfare system is quite different to ours.


    Given these differences, trying to cover all bases, simultaneously, for both the UK and US perspective, is way too complex - and the issues are already complex, enough.

    This is why I suggested splitting the thread into two, several weeks ago - one for DSM and ICD-10 users, and one for DSM and the US version of ICD.


    Having researched and worked on this (and related) issues for almost a year, I most likely have more information about the DSM and ICD revisions on my sites and on my hard drive than anyone else and I am happy to make any information I hold available to others.

    But I don't own this issue.

    There are thousands of ME and CFS sufferers in the US.

    There are now 1,110 members on Cort's forums.

    That's a sizeable forum. Co-Cure has maybe around the same number of recipients signed up for its mailing list. But Co-Cure isn't a discussion board.

    Dan Moricoli's network is popular and I would imagine his network has a high percentage of US users. He has forums, blogs and information resources. He also networks with "names".

    Facebook has dozens of CFS and ME related groups. It's useful for spreading the word, getting folks to sign up to petitions etc. But I don't find it a good place to carry out discussions. You cannot format posts, you cannot edit posts after 15 mins, it's hard to find stuff from weeks back. It's hard to keep track of where information (or misinformation) is being republished (or to correct it, if you need to keep joining pages in order to leave comments.)

    In fact I hate Facebook. I live in dread of a PM inadvertently ending up on someone's Wall or to find that I have sent someone a puppy, or a pair of fluffy handcuffs, instead.


    Be aware that the zeitgeist in some quarters may be that "XMRV will change / has already changed the landscape" and that DSM is now irrelevant and why are you bothering monitoring all this DSM and ICD stuff...

    Since October, the focus for many has understandably been on XMRV, but other issues are still worthy of attention.


    Yes, DSM has global implications, but you need to be looking for direction from within the US from people better equipped than I am with a thorough understanding of your own medical and welfare systems and fed agencies, and who are knowledgeable about your CFS and ME patient organisations and around your US patient organisation politics.



    There will be a DSM draft, then field trials, then a beta draft, and no doubt a lot of argy bargy in between, especially since the APA is also looking into the concept of scrapping categories in favour of "dimensions" - this thing could run and run...

    But the first draft is expected on 10 February. I am not necessarily expecting it to be particularly detailed for the section of relevance to us.

    That's not long, and the consultation process may be only a couple of months - possibly three, if we are lucky. All the relevant information about the consultation process will be up on my site as soon as it is available.

    What I would suggest you might do is this:

    Try and gather a few interested US folk around you in the next week or so who are prepared to commit to sharing the load. Put out a plea on this thread or hop onto some of the most active threads on this list and ask for help there, or start a new thread just to garner assistance and then come back to this thread.

    Fresh_eyes has said that she was interested in setting up a website for the issue - I don't know what fresh's current plans are - but talk to fresh.

    Initially, try and gather three of four around you (any more and it can be hard keeping everyone in the loop and a pig with two masters never gets fed).

    Approach US advocates: talk to Cort - what's Cort being doing around DSM and ICD-10-CM in the past couple of years? Sign up to Dan Moricoli's network and see who is posting on the blogs there:

    John Herd; Mary Schweitzer; Kaly Castle. Contact seasoned US advocates, like Co-Cure mailers Jill McLaughlin and Jean Harrison (MAME).

    Approach your US advocacy organisations and ask them to set out:

    What is their position on current proposals for your ICD-10-CM and what action are they engaged in?

    Are they are monitoring the DSM revision process?

    Are they intending to respond in the consultation process?



    The consultation process might possibly be subject to certain requirements, like the format and the citing of research papers.

    I am not saying that patients should not be involved in the consultation process but your advocacy orgs and your clinical and research professionals need to involve themselves, too.

    Contact Lenny Jason and Fred Friedberg, they should know who the CFS friendly professionals are who might be encouraged to get involved in the consultation process.

    So my advice is, as time is fairly tight, don't spend weeks preaching to the choir on Facebook but gather around you a few US people and talk to US advocates who are already involved in campaigning; try to get professionals involved and establish what your US patient orgs are doing.

    Suzy
  10. mezombie

    mezombie Senior Member

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    Hi Suzy,

    The problem, of course, is that those of us concerned with this issue are not carers but sick patients.

    I am wary of commiting to doing much on this as I am dealing not only with my own health problems but other challenging family situations. That does not mean I don't think it's important!

    Reminding the psychologists who understand our situation that we are counting on their input, like Lenny Jason and Fred Friedberg, would be great. I suspect they have a lot on their plate.

    Mary Schweitzer is aware of this matter but quite sick.

    Another potential resource that comes to mind is (no hissing, please) the CAA--because they have engaged a consulting company that I believe has the resources and knowledge to get involved (B & D Consulting)

    Suzy, do you know if the consulting process allow for input from the public, including invidual patient advocates? Or are the "consultants" usually hand-picked?
  11. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    Hi Marie,

    My understanding is that it will be a public consultation process and that all stakeholders and interest groups, including patients, will be able to make responses to the draft guidelines.

    There is currently no information available on the consultation process itself on the APA's DSM-V pages but I am monitoring the site on a daily basis. I cannot confirm at this point what format responses to proposals will be expected to take, for example, length, format, or whether responses will be expected to supported with citations.

    There is a document on the APA's website which sets out how suggestions for changes to DSM-IV should be submitted, but I understand that this is a document that has been in use for some time and I have not flagged it up because different instructions may be published when the draft is published.

    The APA is in the process of setting up new webpages. The newly designed webpages will carry the draft proposals. A source with a source on the DSM-V Task Force has told me that the APA may launch the new webpages prior to 10 February for testing purposes but that the draft, itself, isn't expected until 10 Feb.

    This is the page to watch on the APA's site for announcements: http://www.psych.org/MainMenu/Research/DSMIV/DSMV.aspx

    This is the APA DSM home page: http://www.psych.org/

    This is my site: http://dxrevisionwatch.wordpress.com

    This is the page that info on the consultation process and draft will be posted: Shortlink for DSM-5 proposals Sub page 2:


    http://wp.me/PKrrB-jZ



    Suzy
  12. Dx Revision Watch

    Dx Revision Watch Suzy Chapman dxrevisionwatch.com

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    Marie wrote:


    Hi Marie,

    I'd like to clarify a couple of points:

    I know that Mary is aware of the DSM-V revision issue. I have discussed this (and related MUS issues) with her during the course of last year and Mary is aware of my "Elephant in the Room" series of reports, published via Co-Cure and on my own sites.

    In providing teejkay with a list of names of US advocates, it was not my intention to imply that I felt these individuals should be approached with a view to their becoming actively involved in this issue, themselves, if they are not well enough to do so, or because they have other projects on the go, or because they choose not to.

    My intention was that seasoned US activitist are likely to be in a position to suggest the names of clinicians, researchers and ME and CFS friendly professionals from the field of psychiatry and psychology, and contacts within US patient rep organisations who might be encouraged to respond in the DSM-V draft consultation and that they might also be able to give some advice to teejkay and any others on this board, how this issue might best be approached from the US perspective.

    Jason and Friedberg are psychologists but also patient advocates, with strong links to US advocacy organisations. I am sure that both are aware of the forthcoming DSM draft.

    Again, my suggestion was that teejkay (and any assistants she can muster) might approach these two on the basis that they might be in a position to suggest or to encourage other psychologists, psychiatrists and patient organisations to monitor and participate in the draft consultation - if the CFS and ME corner is going to need fighting.

    I would also hope that they would be participating in the consultation process, themselves.

    My own view is that it should not be necessary for either of these two to be recipients of multiple emails. So my suggestion would have been for one or two people to undertake to contact these two, and establish a rapport - I'm sorry that I did not make this clearer.

    I am a carer but I am well aware that many ME and CFS sufferers have limited energy for advocacy - which means that what energy can be spared needs to be channelled. I would rather see limited energy being used to identify and contact a number of potential professionals who might be encouraged to respond in a consultation process.

    I've already highlighted that there are over 1000 members on these forums and that there are some threads that have attracted over a thousand postings in just two or three weeks.

    One thread: http://forums.aboutmecfs.org/showthread.php?2105-The-Fight-is-on-Imperial-College-XMRV-Study/page125

    has garnered a staggering 1301 postings since the McClure/Wessely paper was published earlier this month.

    Perhaps some of that passion might be tapped into and redirected into identifying and making considered approaches to selected US professionals and also to establish what US patient organisations are already doing about ICD-10-CM, what their positions are on the current proposals for ICD-10-CM and whether they are monitoring the progress of the DSM revision and whether they intend to submit a response when the early draft is released.

    I face similar problems within the UK. We are a far smaller country. The pool of active ME advocates is very small. Some of those who might ordinarily have become involved in these issues have, this year, had other commitments. There has not been a great deal of interest within the UK so far, in the issue of DSM and ICD revision and patient organisations remain silent.

    Other patient communities and interest groups for controversial disorders have been monitoring the revision process and feeding into it over the past couple of years.

    I will continue to monitor both DSM and ICD-11 and to research and obtain information and make it available to others via my websites and via mailing lists - but ultimately, US patients and advocates will need to find their own path through this.

    I hope that people who have been able to be active in other threads might come forward to offer help to fresh_eyes, teejkay and others and as I say, any material that I have that can be of use to others I am very happy to put at their disposal.

    Suzy
  13. Gerwyn

    Gerwyn Guest

    These are probably the worst stats i,ve ever seen some of the confidence intervals vary by !0000%! their answer to the problem of medically unexplained symptoms is TO CHANGE THE LABEL to somatoform disorder. The bright spot even by their data only 30% of CFS could be attributable to somatoform disorder.They are also hedging their bets now that cfs could have an organic AND a psychological cause coexisting in the same patient . The data would be funny if It wasn,t potentially so serious We need an advocate to blow this out of the water!It is nice to know however that they have admitted that they have nothing to do with medicine as they will only deal with the medically unexplained ---- wait a minute though , Isn,t somatoform disorder medically unexplained?
  14. Gerwyn

    Gerwyn Guest

    The way to side step all of this is to focus on post exertional fatigue malaise etc If every study involved this measurement objectively then The cdc oxford etc criterea would be redundant and we could escape the classification entirely perhaps leading to a renaming of our disease
  15. mezombie

    mezombie Senior Member

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    US ME/CFS advocacy organizations likely to be on top of this

    Several US ME/CFS advocacy organizations endorsed a letter requesting a Congressional hearing on psychiatric diagnoses several years ago. Here are the groups' names along with their contact person:

    The Wisconsin Chronic Fatigue Syndrome Association (Pat Fero, Executive Director)

    Mothers Against Myalgic Encephalomyelitis, aka MAME (Jean Harrison)

    CFSFacts.org (Karen Campbell)


    I found them at http://www.psychdiagnosis.net/endorsers.html

    Anyone with some steam might want to contact them to see what they are planning to do with the DSM-V revision process.

    Marie (out of steam)
  16. Nina

    Nina Senior Member

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    Hi everyone,

    I have been following this for a while now but to be honest, I was never sure what exactly is happening and if there is any action required yet.

    I would be more than happy to contribute, but I need others to guide me. Most of the texts are too long for me to comprehend. Maybe we should create some kind of "international DSM-V task force"?
  17. starryeyes

    starryeyes Senior Member

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    me agenda - thank you for that explanation and advice. That's really valuable. I forgot I had gotten involved in this thread! I suffer from bad cognitive dysfunction.

    I just asked what we can do about this on another thread and here you have answered me weeks ago. I did remember this thread existed and I planned on coming in to look at it again at some point but I had in my mind that all of it was over my head and I wasn't able to make heads or tails of it. However, I now feel like I have a place to start.

    Marie- thank you for your advice too. Leonard Jason is one of my favorite CFS advocates. :)

    Thank you very much me agenda. I'm going to look this over again when I'm less brainfogged. I really appreciate your help here.

    I'm glad to see others here from the US interested in helping. That's a good list too, Marie.

    Thanks for explaining more about what we should and shouldn't do me agenda. I'm feeling fired up about this! It will be great if we can take some action.
  18. starryeyes

    starryeyes Senior Member

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    I don't like FB for many of the reasons you've listed but I didn't know that PMs get put up on Walls there sometimes. :eek: Can you or someone here explain the sending of puppies or fluffy handcuffs? :tear: I left this thread.. started going about other business here and I just couldn't get that out of my mind. I had to come back and ask. :innocent1:
  19. mezombie

    mezombie Senior Member

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    Reminder: APA to post proposed DSM changes tomorrow, Feb. 10

    A new website, www.DSM5.org, is expected to be launched tomorrow, February 10.

    The much awaited proposed changes to the previous DSM should be posted there as well as information on how to comment.
  20. starryeyes

    starryeyes Senior Member

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    Bay Area, California
    Very good Marie. I'm glad to see that.

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