Bob
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To back up some of my points:
Somatoform Disorders.
(WPA Series in Evidence & Experience in Psychiatry)
Volume 9
2005
Editors: Mario Maj, Hagop S. Akiskal, Juan E. Mezzich and Ahmed Okasha
ISBN: 978-0-470-01612-1
http://eu.wiley.com/WileyCDA/WileyTitle/productCd-0470016124.html
Unless I've totally misinterpreted it, the above quote seems quite clear that Wessely can see no differentiation between CFS and an anxiety disorder. (He's not necessarily equating them, but he can't differentiate them.)
This, to me, is disturbing, and IMO startlingly ignorant.
The reason, I believe, that he cannot differentiate the two, is that he is only interested in the 'fatigue' aspect of the illness, as evidenced by the following quote:
In terms of the biological aspects of CFS, my understanding is that he believes that a biomedical 'trigger' is only involved in the initial stages of CFS, and then it becomes irrelevant to the perpetuation of symptoms. (I can't remember if he believes that a biological trigger is necessary).
These quotes need to be read in the full context of the whole paper, which is rather contradictory, and vague in many places, IMO. But my understanding is that these quotes follow the general thrust of the paper as a whole.
See my other notes on this paper, here:
http://forums.phoenixrising.me/inde...nding-up-for-science.20231/page-7#post-310521
Somatoform Disorders.
(WPA Series in Evidence & Experience in Psychiatry)
Volume 9
2005
Editors: Mario Maj, Hagop S. Akiskal, Juan E. Mezzich and Ahmed Okasha
ISBN: 978-0-470-01612-1
http://eu.wiley.com/WileyCDA/WileyTitle/productCd-0470016124.html
Chapter 5: Chronic Fatigue and Neurasthenia
Chronic Fatigue and Neurasthenia: A Review
Michael C. Sharpe and Simon Wessely
[Page 253]
Medical or Psychiatric Diagnosis?
Parallel with the debate about aetiology is the argument about whether CFS is most appropriately regarded as "medical" or as "psychiatric". For the same symptoms, the medical diagnosis may be CFS and the psychiatric diagnosis may be an affective, anxiety or somatoform disorder. It can be argued that neither of these diagnoses alone is adequate. The proper use of the DSM-IV axes allows the patient to be given both a medical (Axis III) and a psychiatric (Axis I) diagnosis: the final diagnosis may, for example, be CFS/generalized anxiety disorder. However, we ideally need a classification that avoids two diagnoses being given for the same symptoms. This is a task for the authors of the forthcoming DSM-V [7].
I have yet to get hold of a complete copy of this paper, but I've read quite a bit of it - enough of it to understand the model of illness being promoted.Unless I've totally misinterpreted it, the above quote seems quite clear that Wessely can see no differentiation between CFS and an anxiety disorder. (He's not necessarily equating them, but he can't differentiate them.)
This, to me, is disturbing, and IMO startlingly ignorant.
The reason, I believe, that he cannot differentiate the two, is that he is only interested in the 'fatigue' aspect of the illness, as evidenced by the following quote:
A Discrete Disorder?
Although CFS is often regarded as a discrete condition, much as neurasthenia used to be, the severity of the symptoms of fatigue is continuously distributed in the general population [2] and the case definition can also be regarded as simply defining cut-off points on these continua.
In terms of the biological aspects of CFS, my understanding is that he believes that a biomedical 'trigger' is only involved in the initial stages of CFS, and then it becomes irrelevant to the perpetuation of symptoms. (I can't remember if he believes that a biological trigger is necessary).
These quotes need to be read in the full context of the whole paper, which is rather contradictory, and vague in many places, IMO. But my understanding is that these quotes follow the general thrust of the paper as a whole.
See my other notes on this paper, here:
http://forums.phoenixrising.me/inde...nding-up-for-science.20231/page-7#post-310521