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Your urinary tract infection is in your head - Guardian article

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
No, not an anatomical paradox, but what some British doctors have been telling people with UTIs/cystitis, the Guardian reports.

Research published in Clinical Microbiology and Infection found that 19% of infections were being missed by standard culture tests. Not such a big deal, of course, that a test should be imperfect. But the way some GPs are responding to negative test results is a very big deal indeed.

Prof James Malone Lee, who runs a specialist clinic for chronic UTIs at Whittington Hospital in London, highlighted the inadequacies of current testing in parliament last year. “The patients attending our centre describe frequent occurrences of them presenting with typical symptoms of urinary infection but being denied treatment because the tests are negative,” he said. “They are told emphatically that nothing is wrong.

The consequences for the minority of women who suffer chronic infections could be devastating, he added. “It is appalling that patients coming to our centre have been told that their problems are psychological.

Psychologising of medical conditions seems to be epidemic in the UK now.

One of the report's authors had some advice for GPs that I'm sure we all wish they would listen to and apply across the board:

“The woman that is visiting you with typical urinary complaints has an infection. There is nothing more to explore.”

Radical idea that — doctors starting with the idea that symptoms might indicate a medical condition. Think it'll catch on?
 
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TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
Unfortunatey one of the best chances for ME to be taken seriously is that as the number of patients being dismissed with psychological explanations of physical illnesses grows, so will public anger and understanding for our situation.

It's a bit of a paradox for the psychs - as their empire grows, so does the number of vexatious patients. I'd expect them to have a plan for that. How did this story get past the SMC?
 
Messages
2,125
Psychologising of medical conditions seems to be epidemic in the UK now

........and if it continues then so will the number of sick/untreated people probably ending up on anti-depressants

https://www.theguardian.com/society...sant-prescriptions-doubled-in-the-last-decade

"Simon Wessely, president of the Royal College of Psychiatrists, says there is no evidence – yet – that mental illness is increasing."

No, just lots of other illnesses being treated as mental illnesses.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
........and if it continues then so will the number of sick/untreated people probably ending up on anti-depressants

https://www.theguardian.com/society...sant-prescriptions-doubled-in-the-last-decade

"Simon Wessely, president of the Royal College of Psychiatrists, says there is no evidence – yet – that mental illness is increasing."

No, just lots of other illnesses being treated as mental illnesses.
That was an interesting article.

“General practice has been under a lot of pressure,” says Dr Liz England of the Royal College of GPs, who practises in inner-city Birmingham. “In the past we might have been able to spend more time with patients, and to give that lower level of counselling. We don’t have that luxury now.”

And while she welcomes the increase in the numbers of counsellors across the country, she says most are trained to deal with mild to moderate anxiety and depression, and so may not be able to help people who have suffered trauma or abuse. Complex psychotherapy and other such services are less readily available. “A lot of the funding has been diverted into IAPT at the expense of other psychological services,” she said.
Are we witnessing the trivialisation of mental health? The spread of "lower level counselling"? McCounselling? The introduction of Mental Health Lite? Nice to see that those mental health professionals whose funds are being diverted and squandered are noticing - more potential allies?

Wessely says we need both – pills and counselling. If he were ill, that is what he would want for himself, he says. He thinks antidepressants are being wrongly demonised and are, if anything, under-prescribed. Far more treatment of mental illness is needed.

Knowing that Wessely likes to position himself to win whichever way the wind blows, I was wondering how he wins with the rise in antidepressant prescriptions. Does he have any links to the pharma industry? I came across this:

https://truthman30.wordpress.com/20...sident-of-the-royal-college-of-psychiatrists/

There are a couple of industries that rely on placing themselves in a postion to win whatever happens - the betting industry, the insurance industry. Their livelihood depends on them putting themselves in a position to make a profit whatever the outcome. Has Wessely got any pals in the insurance industry?

http://www.sophiaandme.org.uk/collusion.html

Simple Simon, the Finger-In-Pie-Man
 
Messages
2,125
Oh the irony:

RC of Psychiatrists‏@rcpsych 2h2 hours ago


Psychiatrists experiencing difficulties during training can access free, confidential support. Call on 02072450412 http://bit.ly/1SZzFPw

C-u57_8XsAEko4d.jpg


They also like their media coverage:

RC of Psychiatrists‏@rcpsych Apr 28


It was a good week of media coverage following stories in the @guardian, @SkyNews, @HSJnews, @Telegraph and more!

C-gnCkbXsAEksAf.jpg


:depressed:
 
Messages
69
Most of times it will be viruses, and when bacteria they don't perform the specific tests. Lots of bacteria types require specific test, just regular grow tests won't show anything.
 
Messages
15,786
All this time, doctors have focused on bringing treatments up to the level that they cause patients to become fully functional again. But it turns out that they just needed to redefine everyone who doesn't drop dead from the treatments as "recovered". And with a little more ingenuity, I'm sure Sir Simon Wessely can find a way to include even the deceased in his tally of successes.

Why does anyone take these quacks seriously? We can barely parody them anymore, when their own claims are already so blatantly over the top.
 

Hip

Senior Member
Messages
17,824
Most of times it will be viruses, and when bacteria they don't perform the specific tests. Lots of bacteria types require specific test, just regular grow tests won't show anything.

I don't know what the standard NHS test for UTI's involves, but I guess it is quite possible that the standard test may miss certain rarer bacterial causes of UTIs, if the test does not use the right culture medium for those bacteria.

It would be interesting to hear from someone who knows about the NHS test for UTI.

For many years I had a recurrent UTI that would normally be quiescent, but would flare up for a few days every two or three weeks. During the flare, I was much more fatigued than normal (UTIs are know to cause fatigue), and in the flare-up there was also the most goddam awful sewer-like smell from my urine during urination.

Yet in spite of this strong smell symptom, the standard NHS test was unable to culture any organisms from a urine sample taken during one of my flare-ups. Although my doctor did not say my symptoms were all in the mind, but just said that unfortunately the test was unable to find the organisms involved.


According to the Wikipedia UTI article, Escherichia coli is the cause of 80% to 85% of community-acquired urinary tract infections, and Staphylococcus saprophyticus is the cause in 5% to 10%.

Viral and fungal UTIs are rare.
 

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
I don't know what the standard NHS test for UTI's involves, but I guess it is quite possible that the standard test may miss certain rarer bacterial causes of UTIs, if the test does not use the right culture medium for those bacteria.

It would be interesting to hear from someone who knows about the NHS test for UTI.

@Hip - the article that prompted this post gives some more information:

The study, published in Clinical Microbiology and Infection, recruited 220 women who were visiting their GP for UTI symptoms and 86 healthy volunteers, all of whom gave urine samples.

The standard culture test detected bacteria in 81% of the samples. But a more advanced technique, designed to spot tiny quantities of bacterial DNA, found evidence of an infection in 98% of the women with symptoms.

Only about 10% of the healthy women tested positive for bacteria such as E. coli, suggesting that the results were not simply explained by trace levels of bacteria that are always present.
 

Alvin2

The good news is patients don't die the bad news..
Messages
2,996
Unfortunatey one of the best chances for ME to be taken seriously is that as the number of patients being dismissed with psychological explanations of physical illnesses grows, so will public anger and understanding for our situation.

It's a bit of a paradox for the psychs - as their empire grows, so does the number of vexatious patients. I'd expect them to have a plan for that. How did this story get past the SMC?
Thats one way, though i think an identified mechanism and a test is the quicker and more convincing, narcolepsy used to be "caused" by psychological trauma, the discovery of Orexin and discovery that destruction of the cells that generate it cause the disease put the psychological theory to bed permanently.
If Dr Davis identifies the block and can develop a test for it and it has high accuracy it will destroy the psychological camp, much like the proof of helicobacter pylori in the stomach destroyed the stress causes ulcers garbage.
 
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char47

Senior Member
Messages
151
"General practice has been under a lot of pressure,” says Dr Liz England of the Royal College of GPs, who practises in inner-city Birmingham. “In the past we might have been able to spend more time with patients, and to give that lower level of counselling. We don’t have that luxury now.”

And while she welcomes the increase in the numbers of counsellors across the country, she says most are trained to deal with mild to moderate anxiety and depression, and so may not be able to help people who have suffered trauma or abuse. Complex psychotherapy and other such services are less readily available. “A lot of the funding has been diverted into IAPT at the expense of other psychological services,” she said".

Are we witnessing the trivialisation of mental health? The spread of "lower level counselling"? McCounselling? The introduction of Mental Health Lite? Nice to see that those mental health professionals whose funds are being diverted and squandered are noticing - more potential allies?

Yes indeed we are witnessing the growth of mental health lite. There are many MHPs who are very unhappy with the current situation....
In one area of the uk that i'm aware of psychotherapy (& by that i mean the 'proper' kind... ie with someone with a masters degree & who has had (as part of their training), intensive personal psychotherapy themselves), has been left almost non existent. And most of the posts for therapists practicing in a humanistic, person centred way (- you know respectful, egalitarian, compassionate, honouring, no interest in manipulating the patient or being in power), were disestablished in sweeping changes when the adult psychotherapy dept was decimated to make way for lots & lots of CBT for IAPT.
While a tiny amount of non-cbt therapy was allowed to remain within the dept, this was made time limited too, & so now only those patients with 'quick fix' amenable problems get any help at all. Those for whom a few hrs of tinkering would be detrimental because of the complexity/severity of their histories/problems are utterly abandoned.
Everyone, - the therapists, the CPNs, and some of the psychiatrists in the area were, by all accounts, up in arms about it all but istm that most of the ones who argued & fought against it were either made redundant or pressured into early retirement etc, by the CCG.

You only have to read Therapy Today (the British Association for Counsellors & Psychotherapists' magazine (I was flicking through a few copies from recent yrs that i got from a charity shop recently & it was rather enlightening)) to see that there is a raging argument going on.
I read CBT being called both a 'fetish' & a 'cult' (both of which gave me a wry chuckle) and all kinds of other things, by counsellors & therapists extremely unhappy about the way things are/have been going in the NHS. Lots of complaints about the lack of compassion which can be inherent in cbt, poor & inadequate training etc.

But since it's a kind of therapy that fits well into 'outcome measures', tick box thinking, paperwork & 'evidence gathering', its pretty much the only therapy which is easily quantifiable, & so the target driven NHS love it, while many (although of course not all) of the people forced to work within IAPT depts' restrictions are unhappy & leaving.

This idea that almost all ills can be cured if people will just think "right" - ie deny reality & say what fits in, is rampant.
We are just at the 'pointy end'.:meh:

NB i am not knocking CBT per se, its great for what it's great for eg phobias & many cbt therapists are well trained & compassionate, but no guesses which kind the MUS clinics will be getting!:grumpy:

ETA "istm that" in sentence about CCG - i dont have any proof that 'most of them' were made redundant etc, but from what i heard from various people it certainly sounded that way to me.

EDITED - On reflection I thought that in view of the hostile climate towards pwme, & the public nature of this forum, it would be wiser not to include any possibly identifying information of others. Apologies for any confusion caused.
 
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Messages
2,158
While an article like this is deeply worrying on one level, in that lots of people, predominantly women, are yet again being misdiagnosed as 'all in your pretty little head', such an article could also have a positive spin off.

I suggest that doctors reading it might realise that just because their tests don't show a physical illness, this doesn't automatically mean the cause is psychological. It's a useful reminder of the limitations of testing, and the importance of listening to the patient and taking notice of their reported symptoms.

Even, dare I say it, ammunition for patients in helping them persuade their doctors and their friends and families that lack of evidence of physical illness does NOT imply lack of physical illness.

Oh dear, I think I need to lie down (oops, I am already). I just looked on the bright side of a terrible story. What has come over me. Where's my inner cynic? :confused: