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BMJ latest: Fibro, like ME, is a somatoform disorder

Discussion in 'General ME/CFS Discussion' started by Countrygirl, Mar 22, 2014.

  1. Countrygirl

    Countrygirl Senior Member

    I just couldn't resist this after all the fascinating information that has been presented at the conferences in the US this week. Here is the UK's Flat Earth Society's medical profession's latest contribution in the BMJ to the scientific understanding of Fibromyalgia and ME.

    (Fellow Brits, time for a joint cringe!)


    Helping doctors make better decisions :bang-head::jaw-drop:

    Fibromyalgia an unhelpful diagnosis for both patients and doctors
    6 March 2014
    The review by Rahman et al on fibromyalgia [1] describes the disorder as if it is a disease entity characterised by, for example, a certain number of tender points. This is misleading, as tender point counts merely reflect levels of distress. [2] Whilst, indeed because, we recognise the difficulties encountered by this patient group, we suggest that the term fibromyalgia be abandoned for the following reasons:

    1] Fibromyalgia is a dimensional or “continuum disorder” and not a “disease” [3]

    2] FM is strongly associated with other non-musculoskeletal complaints and emotional distress, which are at least as disabling as the somatic symptoms; it is more appropriately described in terms of “polysymptomatic distress”[3]

    3] In our clinical experience assigning a person a label of FM has a negative and disempowering effect on the patient and many of their doctors; once a person ascribes a complaint to, for example, “fibrofog” it suggests that it is external and unalterable. This may transform a person with distress into “a patient with fibromyalgia.”

    4] Because FM overlaps with numerous other disorders with medically unexplained symptoms such as irritable bowel syndrome and chronic fatigue syndrome [3] it is more appropriate to treat them within the same specialised service in the general hospital. Experience in Europe suggests that such specialised units for patients with these disorders can be established with multidisciplinary teams

    Polysymptomatic distress has been recognised as a somatoform disorder, specifically as a somatic symptom disorder or SSD. [4] Of people with fibromyalgia in the general population 40% satisfy criteria for somatic symptom disorder, prompting Wolfe to remark that – “the idea that fibromyalgia is primarily a somatic symptom disorder is well accepted in the pain and psychological literature, but not in the rheumatology, where the dominant idea is central sensitisation”. [3] People with these diverse complaints present to doctors in all branches of medicine, in particular in primary care. A greater awareness of the psychosocial determinants of musculoskeletal complaints would benefit all doctors by helping them to identify these people earlier in their “patient journey” and prevent the medicalisation and potential for iatrogenic harm that accompanies a diagnosis of fibromyalgia. [5]

    [1] Rahman A, Underwood M, Carnes D. Fibromyalgia Br Med J 2014;] 24th February]

    [2] McBeth J, MacFarlane G, Benjamin S, Morris S, Silman A. The association between tender points, psychological distress, and adverse childhood experiences. Arthitis Rheum 1999; 42:1397-1404.

    [3] Wolfe F, Brahler E, Hinz A, Hauser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthritis Care Res 2013; 65: 777-785.

    [4] Somatic symptom and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders, 5th edition. American Psychiatric Association. Washington DC, 2013:309-327.

    [5] Kouyanou K, Pither C, Wessely S. Iatrogenic factors and chronic pain. Psychosom Med 1997; 57:597-604.

    Competing interests: None declared
    Fuschia and Valentijn like this.
  2. maryb

    maryb iherb code TAK122

    oh I'm definitely cringing.....ughhh
    like your 'flat earth society':D:D
    Kati likes this.
  3. Valentijn

    Valentijn Senior Member

    What an idiot. At least there's an intelligent response right after it mentioning physiological abnormalities which have been found in patients. Just have to click on the "Read Responses" tab.
    maryb likes this.
  4. Countrygirl

    Countrygirl Senior Member

    Yes,....................but by a Spaniard and an Australian. :D Not one intelligent response from a British doctor.
    taniaaust1, Valentijn and maryb like this.
  5. Esther12

    Esther12 Senior Member

    Last edited: Mar 22, 2014
    maryb and Valentijn like this.
  6. SilverbladeTE

    SilverbladeTE Senior Member

    Somewhere near Glasgow, Scotland
    They probably still think Tuberculosis is caused by excessive masturbation, in which case, their brains would have melted years ago!

    *thinks about that a minute...*

    Ok, maybe they ARE the exception that proves the rule? :p
    maryb and peggy-sue like this.
  7. Martial

    Martial Senior Member

    Ventura, CA
    haha ahh man some people still have the intelligence of rocks due to protecting points of views and ego.

    Why is there so many studies done by psychiatry for these types of things..

    We can't find any identifiable cause of this persons illness and medicine knows everything, therefore this is all in the patients head.. Need's psychological intervention.

    Needless to say there are numerous studies and proven tests that show plenty of changes in immune response and biological functions that are both very well connected to these types of "dise ease" states of the physical body.
  8. barbc56

    barbc56 Senior Member

    IMHO, the competing interest is illogical thinking. :lol:

    Countrygirl, Valentijn and Kati like this.
  9. Katherine


    Regarding Prof Rahman, who would think that a degree from Oxford would equip you to write such crap.
    Countrygirl and Kati like this.

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