An Investigation into the Relationship Between ME(CFS) and Obsessive-Compulsive Disorder

[Snow Leopard]

What is your view on the above-detailed psychiatric symptoms found in the CCC?

Comorbid disorders at similar prevalences to other similarly disabling chronic illnesses.

 

[TiredSam]

Not as bizarre as the irrational fear of psychology and psychologists that so many ME/CFS patients seem to manifest.

We all have an irrational fear of exercise too, don't forget that!

Those here who are denying the validity of studies that show psychiatric comorbidity in ME/CFS:

Is it possible for someone to disagree with your views without being labelled as having an "irrational fear" or being in denial? Plenty of other places we can get comments like that if we want to. How about "Those here who are questioning the validity of ..."

In my case, I tend to think more scientifically than politically, so I am quite capable of accepting the empirical data without accepting the psychogenic theory. It is not that difficult to do!

How marvellous. You probably find it so easy because your standard for "empirical data" is so low.

 

[Cheshire]

Not as bizarre as the irrational fear of psychology and psychologists that so many ME/CFS patients seem to manifest.

I bet as I criticised the study you're praising I'm included in that.
Can you tell me what is irrational in the arguments I opposed you?
Where do you see that "so many ME/CFS patients" manifest a fear of psychology?

I've never seen anyone denying that there is a high rate of psychiatric comorbidities in MECFS. What we are against is bad science, and the study you're defending is very bad science, (you agreed that their diagnosis rate is a problem), but if you're OK with a telephone diagnosis, what else can I add? There was a study done by Klimas some time ago, that showed a high rate of psychiatric comorbidities, I didn't see a lot of people criticising it, certainly because the methodology was much better (didn't read it personally, so I can't say anything about it.). I just want good psychological studies, with good cohorts of MECFS, good criteria for psychiatric comorbidities, good comparison groups (eg. neurological and non neurological diseases). And really trying to understand how these psychiatric comorbidities are developing, not just resorting to a preconceived and poorly defined psychosomatic assumption.


This kind of "irrational fear of psychiatry" rethoric is DEEPLY insulting, and you know enough of MECFS history to be aware of how it has been used against us. That you're resorting to this kind of arguments is puzzling.

 

[Scarecrow]

But were these CFS empiric case definition criteria used in the OCD etc study in question? In this OCD study they say they used the CDC Symptom Inventory, whose questions can be seen in this questionnaire. I can't see any questions in that questionnaire like "I get little done."

Three questionnaires are used as assessment tools for the empirical criteria. They are the Multidimensional Fatigue Inventory (MFI), the Medical Outcomes Survey Short Form 36 for functional impairment and the CDC symptom inventory. All three were employed in the study we are discussing (see Classification of Subjects in the Methods section). The questions you have highlighted are from the MFI.

Those here who are denying the validity of studies that show psychiatric comorbidity in ME/CFS: I am curious, are you also denying the psychiatric ME/CFS symptoms listed in the Canadian Consensus Criteria document, which are as follows:

No. I already stated in a previous post that I think there is an association between ME (or ME/CFS) and mental health symptoms. In my own experience emotional lability seemed to be an inherent part of my illness in the early years, others I'd be pretty confident are reactions to a combination of factors (including perceptions of ME by doctors & other gatekeepers and the difficulty of living with a chronic illness), and some, as I said before, are a consequence of sleep problems.

I don't really have a strong opinion one way or another about whether psychiatric comorbidity is more common in ME than other similarly disabling chronic illnesses.

All I am trying to point out is that if you use an algorithm which results in about 1 person in 50 meeting criteria for CFS, a reasonable person might question the validity of your algorithm.

The only other CFS criteria that gives a similar prevalence is Oxford. How odd is that? The two case definitions created for research purposes and the ones most despised by ME/CFS patients give the highest prevalence rates. Why wouldn't you question the relevance of research based on these definitions?

 

[lauluce]

@JayS
Like many ME/CFS patients criticizing the somatoform etiologies of ME/CFS, you are not distinguishing between the psychogenic theories of ME/CFS devised by psychologists (which I tend not to agree with), and the empirical data obtained by experiment by psychologists (which provided the experiments are performed properly should be perfectly valid).

Your argument seems to be that because you don't like the psychogenic theories and you think they are wrong, then the empirical data gathered by psychologists by must also be invalid. But as an argument that is a non sequitur; the theories and the data are independent.


I am not coming to ME/CFS from a psychogenic perspective; I tend to see the mental and cognitive symptoms that ME/CFS patients have as caused by an organic physical biochemical dysfunction in the brain. So for me, if some psychologists have found a link between ME/CFS and OCD, then I start to think: what kind of underlying biochemical dysfunction in the brain could give rise to both ME/CFS and OCD.

This is just to give you an example of how you can make use of the empirical data gathered by psychologists, even psychologists who favor psychogenic theories, and analyze it from a biochemical perspective.

I hope you can understand what I am getting at here (I am sure lots of people won't understand it).

tat´s exactly how I think, they might have some common underlying disfunction

 

[SOC]

I think too many patients get caught up in self-focussed thinking about ME. They start thinking that because they have ME and they have xyz symptom, xyz is a symptom of ME. That's a clear logical fallacy. The symptom may be entirely independent of ME, even if it occurred at the same time. ME might have triggered the symptom in that patient based on individual factors that don't exist in other patients. A number of psychological symptoms could fall under this second category. For example, chronic illness can trigger depression in susceptible people. So yes, some people develop depression after they get ME. That doesn't mean depression is a symptom of ME. It means you developed it along side ME. Big difference.

My experience of ill health since the onset of ME does not define ME, nor does that of any individual or even small group of patients. Until we have clear objective signs, it's the overall picture that tells us what are ME symptoms -- the symptoms the majority of us have.

An example -- I have immunoglobulin deficiencies. A number of other ME patients do also. As a type of immune dysfunction, it's logical to guess that it might be a part of the ME picture for us. But as far as is currently known, we are a minority of ME patients. Immunoglobulin deficiency cannot be considered a symptom of ME just because some ME patients developed it after ME onset. The same applies to any other symptom that a minority group of patients has developed, whether that's OCD, depression, or swollen ankles. Our unique experience does not define the illness as a whole.

So please, let's stop with the "I have ME and xyz (OCD, depression, immunoglobulin deficiency), therefore xyz is a symptom of ME. It doesn't make sense and it confuses the picture of what ME likely is and isn't.

 

[Large Donner]

What is your view on the above-detailed psychiatric symptoms found in the CCC?

They are neurological so there is no need for psychiatrists or psychiatry. One could get a carpenter to define such symptoms and he could call them carpentry symptoms, don't mean its a logical statement.

At least a carpenter can plonk a lump of wood on a bench and make observations and statements about it.

Below are the systems of the human body and they can all be dissected in a lab. Note the absence of the "psychiatric system". When you can plonk it on a laboratory table and dissect it then you can make claims about it.

• Skeletal System
• Muscular System
• Nervous System
• Respiratory System
• Cardiovascular System
• Lymphatic System
• Endocrine System
• Digestive System
• Urinary System
• Integumentary System
• Male Reproductive System
• Female Reproductive System

 

[Hip]

We all have an irrational fear of exercise too, don't forget that!

Now that I total agree is a complete lot of nonsense invented by brainless psychological researchers.

Is it possible for someone to disagree with your views without being labelled as having an "irrational fear" or being in denial?

If the anti-psychology tone of this thread were just a one-off case, then I would not make a comment like that; but it seems that because of the disgraceful treatment ME/CFS patients have had in the hands of somatoform psychologists, all of psychology now seems to be tarred with the same brush. So it is hard to open any discussion on these forums about a psychological concept or psychological parameter without incurring criticism, for no other reason than because they are psychological.

What lots of people here often fail to appreciate is that there is a big difference between mental/psychological symptoms (and ME/CFS is undeniably full of various mental symptoms, brain fog being one), and mental/psychological causes (and I will stand up as vociferously as anyone else in saying that ME/CFS almost certainly generally does not have mental/psychological causes).

So when discussing possible OCD / perfectionist traits in ME/CFS, there is no suggestion in my mind that these might be some sort of psychological cause to ME/CFS.

Comorbid disorders at similar prevalences to other similarly disabling chronic illnesses.

That is not what I am getting at. What I want to know is why do ME/CFS patients appear to have no problem with discussing ME/CFS mental symptoms like emotional lability or emotional hypersensitivity, which are found in the CCC, but often get a bit hot under collar when studies show that ME/CFS patients may have mental symptoms or traits such as OCD and perfectionism.

I'd just like to understand why emotional lability or emotional hypersensitivity is "political correct" to talk about, whereas OCD / perfectionism is not.

I've never seen anyone denying that there is a high rate of psychiatric comorbidities in MECFS.

You cannot have been on these forums long, because denying a higher rate of psychiatric comorbidities in ME/CFS seems to be de rigueur here, at least for some patients.

And oddly enough, even when ME/CFS patients grudgingly admit that something like depression is quite high in ME/CFS, they will often tend to concoct a psychological explanation for that depression. For example, patients might say that the depression is caused by being housebound, but deny the depression could be caused by biochemical factors. I have come across this sort of argument many times on this forum.

Yet this denial of a biochemical underpinning for depression in ME/CFS totally contradicts patients' general views on ME/CFS, in which they say the reverse: they deny that ME/CFS could have a psychological explanation, and insist it has a biochemical explanation!

Go figure! It is not a contradiction I can fathom.

This kind of "irrational fear of psychiatry" rethoric is DEEPLY insulting, and you know enough of MECFS history to be aware of how it has been used against us. That you're resorting to this kind of arguments is puzzling.

I know full well the history of ME/CFS, and the damage the certain somatoform psychologists and psychiatrists (ie, the Wessely School) have done to ME/CFS. Because of this damage, I can understand why some ME/CFS patients have tarred all of psychology with the same brush, and are fearful or suspicious of any psychological research or psychological concepts.

But you cannot get away from the fact that ME/CFS involves numerous psychological symptoms, so we should able to discuss psychological research without always assuming that such research is a conspiracy to make ME/CFS look like it has an "all in the mind" etiology.

tat´s exactly how I think, they might have some common underlying disfunction

Thank you @lauluce. It would be more interesting to discuss the common biochemical pathways that OCD and ME/CFS might share. We might learn something there.

Just because this OCD etc study comes from somatoform psychologists who probably interpret their results as evidence for a psychological cause to ME/CFS, it does not mean we cannot use the same data to provide evidence of a biochemical cause for ME/CFS.

In fact, what could be more satisfying than turning their own data against these somatoform psychologists!

So please, let's stop with the "I have ME and xyz (OCD, depression, immunoglobulin deficiency), therefore xyz is a symptom of ME. It doesn't make sense and it confuses the picture of what ME likely is and isn't.

We are discussing studies with large patient groups, so I don't see the relevance of this comment.

They are neurological

Nope they are psychological symptoms.

ME/CFS symptoms like emotional lability and hypersensitivity are psychological/mental symptoms, because they are experienced in your mind. They may have a neurological cause in the brain, but as symptoms they are psychological/mental.

It is very important to distinguish between psychological symptoms (which we have), and psychological causes (which I very much doubt underpin ME/CFS).

 

[Hip]

Three questionnaires are used as assessment tools for the empirical criteria. They are the Multidimensional Fatigue Inventory (MFI), the Medical Outcomes Survey Short Form 36 for functional impairment and the CDC symptom inventory.

Could you please provide a link to where you read that, because I could not find much info on the CDC 2005 empirical criteria for CFS, and how these criteria are deployed.

 

[Large Donner]

Nope they are psychological symptoms.

ME/CFS symptoms like emotional lability and hypersensitivity are psychological/mental symptoms, because they are experienced in your mind. They may have a neurological cause in the brain, but as symptoms they are psychological/mental.

It is very important to distinguish between psychological symptoms (which we have), and psychological causes (which I very much doubt underpin ME/CFS).

Can you please show me an autopsy of a mind.

Secondly if someone perfectly healthy cries at a sad movie is that a "psychological symptom."

Emotional lability, I am guessing you are going by some tick sheet DSM type "diagnosis" that desires not to describe normal human responses to a range of potential situations and mixes it in with something that could be way on the other extreme with the mechanism being disease process in the brain.

By your logic autism and Alzheimers are in your mind because......

they may have a neurological cause in the brain, but as symptoms they are psychological/mental.

Please can you tell me the mechanism of how such things jump out of the brain and travel to the "mind" where somehow they are no longer in your brain. A diagram or even a photograph of an autopsy showing this journey and picturing the brain on one side of an autopsy table and the mind on the other will suffice.

Hypersensitivity is a mental symptom cos its in your "mind"?

What on earth are you talking about?

hypersensitivity
[hi″per-sen″sĭ-tiv´ĭ-te]
a state of altered reactivity in which the body reacts with an exaggerated immune response to aforeign agent; anaphylaxis and allergy are forms of hypersensitivity. The hypersensitivity statesand resulting hypersensitivity reactions are usually subclassified by the Gell and Coombs classification. adj., adj hypersen´sitive.
contact hypersensitivity that produced by contact of the skin with a chemical substancehaving the properties of an antigen or hapten.
delayed hypersensitivity (DH) (delayed type hypersensitivity (DTH)) the type ofhypersensitivity exemplified by the tuberculin reaction, which (as opposed to immediatehypersensitivity) takes 12 to 48 hours to develop and which can be transferred bylymphocytes but not by serum. Delayed hypersensitivity can be induced by most viralinfections, many bacterial infections.......

http://medical-dictionary.thefreedictionary.com/hypersensitivity

 

[Hip]

Can you please show me an autopsy of a mind.

What's your point, if any?

 

[Large Donner]

What's your point, if any?

You cant show me an autopsy of a mind.

 

[Hip]

You cant show me an autopsy of a mind.

And you can't show me, nor measure on any instruments, your personal mental experience of the color red. Red as it appears in your mind. Does that mean your experience of red does not exist?

 

[Large Donner]

Everybody has OCD, but its level is different for everyone. Some people like to have all of the tins in the cupboard facing the same way, some people like to do tasks at certain times in the day

Hold on!!! ............She might have a point here,............. I always take a shit at 9am.

 

[Large Donner]

 

[SOC]

Hold on!!! ............She might have a point here,............. I always take a shit at 9pm.

I organize the clothes in my closet! I separate the knives from the forks from the spoons in my silverware drawer! I take a shower at the same time everyday! Not only that, I put the garbage can out at the curb on the same day every week! OMG! I must have OCD!

 

[Hip]

Sorry you got that wrong, @Large Donner: you just showed me my personal mental experience of the color red.

I asked to see your personal mental experience of the color red.

 

[Hip]

Hold on!!! ............She might have a point here,............. I always take a shit at 9am.

I organize the clothes in my closet! I separate the knives from the forks from the spoons in my silverware drawer! I take a shower at the same time everyday! Not only that, I put the garbage can out at the curb on the same day every week! OMG! I must have OCD!

Trite sense of humor perhaps, but that's not OCD.

 

[Large Donner]

Sorry you got that wrong, @Large Donner: you just showed me my personal mental experience of the color red.

I asked to see your personal mental experience of the color red.

I just showed you it using my brain and we both agree its red. Now you show me an autopsy of a mind. Unless you want us both to attend an fMRI, at the same time to see my personal experience of the colour red, a which would be on my brain. Following which we can look at the video of my brain and then you can show me another video of my experience going from my brain to my "mind"? ...except you could not!!!

Its your claim that........

ME/CFS symptoms like emotional lability and hypersensitivity are psychological/mental symptoms, because they are experienced in your mind.

...not mine. Therefore your claim needs to be proved by yourself not me. I even showed you how warped your understanding of the term hypersensitivity is and you just ignored it. Very strange as you claim its a "mind based mental symptom" and the definition I provided talks about allergies, the immune symptom, etc etc.

For the benefit of ease of reply here is the definition again to save you scrolling up to look for it..

hypersensitivity
[hi″per-sen″sĭ-tiv´ĭ-te]
a state of altered reactivity in which the body reacts with an exaggerated immune response to aforeign agent; anaphylaxis and allergy are forms of hypersensitivity. The hypersensitivity statesand resulting hypersensitivity reactions are usually subclassified by the Gell and Coombs classification.

The above definition can be seen objectively and measured numerous ways.

Either way we both agree I showed you the colour red objectively. Now can I have that autopsy photograph of a mind, one being extracted from a brain would be of immense interest to me.

 

[Hip]

I have never seen anyone get themselves into such a confused crossed-purposed discussion as you have done, @Large Donner.

I am talking about emotional hypersensitivity, and you bring up allergies?!

If you are struggling to get to grips with something as straightforward as that, I have my doubts that you will ever get a handle on the philosophical concepts behind mental qualia such as color sensation.