Review: 'Through the Shadowlands’ describes Julie Rehmeyer's ME/CFS Odyssey
I should note at the outset that this review is based on an audio version of the galleys and the epilogue from the finished work. Julie Rehmeyer sent me the final version as a PDF, but for some reason my text to voice software (Kurzweil) had issues with it. I understand that it is...
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BMJ Opinion - "Missing the psychosocial diagnosis—a form of institutionalised malpractice" !!!

Discussion in 'Other Health News and Research' started by lilpink, May 21, 2018.

  1. lilpink

    lilpink Senior Member

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  2. Lisa108

    Lisa108 Senior Member

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    Poor lonely psychologists are complaining that medical doctors should refer more patients to them, instead of spending time and money on thorough physical exams.
    :alien:
     
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  3. SilverbladeTE

    SilverbladeTE Senior Member

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    I just pray one day, these charlatans and shysters are tried, convicted and broken, their "snake oil" sham derided throughout history
     
  4. alkt

    alkt Senior Member

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    unfortunately this kind of thing will be taken up simply to save cost look at what is happening with iapt in England they want these people to force the sick and disabled to work instead of providing the so called safety net that we all pay taxes for. all under the guise of improving mental health and inclusion the right wing spin on coercion and abuse is sickening.
     
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  5. SilverbladeTE

    SilverbladeTE Senior Member

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    Somewhere near Glasgow, Scotland
    but there are NOT ENOUGH jobs any more anyway, so it's a stupid idea to begin with
    and now, jobs aren't jobs for most, they are true "wage slavery" at best, if not worse (such as zero hour contracts)

    not of course that the Tory MP *vermin* would know, constantly voting themselves pay rises and perks

    hard fact: most jobs are on their way out, and it will only get worse as cybernetics/advanced tech improves

    really,. some of this IS "Aktion T 4" by stealth, the smug snide nastiness exposed by some of the politicians and their backers, what has happened to us, the collusion and crimes exposed but never punished by law (oddly enough) of ATOS and CAPITA (whistle-blowers exposing fact they are ordered to fraudulently deny many claims etc)
    ...it all stinks, they haven't the guts to wear lightning runes on their collars or deaths heads on their hats.
    same sodding evil
     
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  6. lilpink

    lilpink Senior Member

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    Indeed, what is happening in England is dreadful, but those behind IAPT in England are seeking to expand their model across the globe. In this opinion piece we have a professor from Canada, a professor from New Zealand and the vice president of research and policy on the American Board of Family Medicine. The reference that they give –

    Nimnuan C, Rabe-Hesketh S, Wessely S, et al. How many functional somatic syndromes? J Psychosom Res 2001;51(4):549-57.

    - to illustrate ‘very high rates of medically unexplained symptoms’ is the same one that is repeatedly used to drum up support amongst doctors and NHS commissioners for the MUS arm of the IAPT programme. The fact that this study and paper has serious limitations doesn’t seem to matter.
     
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  7. lilpink

    lilpink Senior Member

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    A comment was made to the BMJ article but it clearly didn't pass moderation. Let's see if this one does? What's the betting it doesn't?:
     

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  8. lilpink

    lilpink Senior Member

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    Err.. no! Hasn't made it through moderation it seems.
     
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  9. lilpink

    lilpink Senior Member

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    I spoke too soon. 3 comments have been passed and appear online:
     

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  10. alex3619

    alex3619 Senior Member

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    MUS is “institutionalised malpractice” so far as I am concerned, as is much of the DSM and all psychogenic diagnoses. They are most likely various forms of category mistake.
     
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  11. alex3619

    alex3619 Senior Member

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    "Some are reluctant to explore psychosocial issues in case they open Pandora’s Box.[1] (Ironically, hope lies at the bottom of this Pandora’s Box.) "

    Hope in this case is in smashing the box with a sledgehammer, then incinerating it. Social issues do occur, brain issues do occur, there are interactions, but the in-between psych stuff is very confused. I think we could get rid of all of it in most cases, and just use neurological and psychological (not psychiatric) approaches, but this would take decades of development to happen if there were will to do so ... which there isn't. Social support is also critical, but BPS advice is destroying social support networks via public and government influence .. BPS is currently part of the Pandora plague, not wings of hope.
     
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  12. ScottTriGuy

    ScottTriGuy Stop the harm. Start the research and treatment.

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    My contribution waiting for moderation:

    Given that medical error is the 3rd leading cause of death in the US (and probably very similar rates in other 'developed' countries), and misdiagnosis of biological / organic illness as psychological the greatest contributor to these deaths, this editorial essentially promotes greater iatrogenic harm and death.

    The last thing the medical system - and patients - need is more psychologizing of physical symptoms.

    History is rife with examples of the medical establishment attributing psych-social explanations to physical diseases: multiple sclerosis, epilepsy, ulcers and on and on.

    Yet these authors want more of this harmful practice in the medical system.

    Institutionalized malpractice indeed.
     
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  13. Deepwater

    Deepwater Senior Member

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    I just googled one of the authors for fun, Bruce Arroll, and he's into a psych treatment for this that and yon called ACT (or FACT if it's focused) in which - so far as I can make out because it's not lucidly explained, patients are persuaded to surrender their souls:
    https://www.goodfellowunit.org/site...ed_Acceptance_and_Commitment_therapy_2017.pdf

    A guidance document for general practice which BA co-authored gives examples of how FACT can be used for people with diabetes and high blood pressure as well as 'fatigue' and stuff, and includes the rather worrying maxim "diagnosis is the distraction". It also introduces the creepy term "transdiagnostic", which would appear to be newspeak for a-suitable-target-for-misappropriation-by-psychiatrists (or am I being cynical?):-
    https://www.pharmac.govt.nz/assets/ss-mental-health-4-f-act-for-medical-care-prof-bruce-arroll.pdf

    :nervous::nervous::nervous::nervous:
     
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  14. lilpink

    lilpink Senior Member

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    A female gynaecologist, Dr Frodsham who has a special interest in psychosexual medicine, tweeted about this BMJ Opinion piece - . I suggest that problems with this tweet are:

    1. The unquestioning acceptance that ‘up to 55%’ of gynae patients have MUS, and that gynaecologists are not instead misdiagnosing at that rate.
    2. That doctors should be ‘prepared’ for this. If they’re thinking that up to 55% have MUS they’re less likely to believe their patients and go the extra mile to find out what is actually wrong with them.
    3. The inference that saying ‘I don’t know’ to patients makes it all OK. It would be great of course if doctors admitted that they didn’t know, instead of imposing a ‘psychosocial diagnosis’ as a default setting, but even better would be – ‘I don’t know but I’m going to do my best to find out’, or if they’re not allowed to do that then - ‘I don’t know, and I’m so sorry but the NHS isn’t prepared to pay for me to try to find out why you’re suffering’.
    4. She says that the IPM, the Institute of Psychosexual Medicine, has been training doctors, presumably on how to explain their MUS to patients, since 1974. An example of this ‘training’ would appear to be this presentation https://www.researchgate.net/publication/321492404_PPS_RCOGIPM_Presentation_final_J_Penman_21112017 given by Dr Jean Penman (a PhD, not a medical doctor) in November 2017 to the RCOG Annual Professional Development Conference - RCOG Annual Professional Development Conference as part of ‘Stream 6’ by the Institute of Psychosexual Medicine (IPM) and British Society of Biopsychosocial Obstetrics and Gynaecology (BSBOG). Did anyone know that there was a ‘British Society of Biopsychosocial Obstetrics and Gynaecology (BSBOG)’? That’s truly alarming! Dr Penman has very recently given another (similar or the same perhaps) presentation also entitled ‘Medically Unexplained Symptoms’ to another RCOG Professional Development Conference this May- RCOG Northern Professional Development Conference (Stream 12). Dr Frodsham presented in the same stream as Dr Penman for both Conferences with her presentations on ‘Control in Obstetrics’. I must say I’m rather glad that I’m past child-bearing age.
    Dr Frodsham, referring to that same May RCOG Conference, also tweeted this - - with a picture of a slide from Dr Penman’s presentation (and yes, it does appear to be the same presentation from 2017) showing the results from the Nimnuan, Hotopf and Wessely 2001 study that the IAPT and MUS proponents like to quote so often. Dr Frodsham doesn’t mention the limitations of that study, but maybe Dr Jean Penman didn’t bother to tell her and the rest of the audience, even though these limitations had been previously pointed out in an (unanswered) email sent to Dr Penman to try to stop her repeating her error in front of another major RCOG Conference. You’d have thought that a consultant gynaecologist like Dr Frodsham would be above blind acceptance of what she is being told, but it would appear not. (What is it about doctors that seems to make them so gullible?)

    As for a ‘clear plan’ to help these ‘MUS’ / ‘PPS’ patients, well I could suggest one!
     
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  15. lilpink

    lilpink Senior Member

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    Some additional information about Dr Leila Frodsham


    It would seem from this - http://webcache.googleusercontent.c...bstract_Booklet.pdf &cd=2&hl=en&ct=clnk&gl=uk that Dr Frodsham was the Chair of the Institute of Psychosexual Medicine from 2012 to 2015 and that she gave the keynote lecture entitled ‘The hidden epidemic - sexual dysfunction and medically unexplained symptoms’ at the IfWH Annual Conference held at UCL this April. ( IfWh is UCL's Elizabeth Garrett Anderson Institute for Women's Health - https://www.ucl.ac.uk/womens-health/ - for ‘better lives for women and babies across the world’). She is a Consultant Gynaecologist at Guy’s and St Thomas’ NHS Foundation Trust and is a ‘block lead’ at King’s College Medical School. No surprises there.

    How is it that one flawed Wessely study - see this paper - https://www.ncbi.nlm.nih.gov/pubmed/11448704 or this paper - https://www.ncbi.nlm.nih.gov/pubmed/11595242 - can be allowed to wreak such havoc?
     
  16. lilpink

    lilpink Senior Member

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    Thanks to Emma Joy for this reply to Leila Frodsham's tweet -




    You never know, there's always an outside chance that Dr Frodsham and/or the IPM and RCOG will take notice and go and look up the paper and have a serious rethink.
     
  17. lilpink

    lilpink Senior Member

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  18. Alesh

    Alesh Senior Member

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    I have just read Primo Levi's "If this is a man". What psychiatrists did to patients with ME is another holocaust. It is even more monstrous than the nazi one: There are more victims and it is happening much longer. We are isolated like the prisoners in Auschwitz behind the double barbed wire. The outer world isn´t aware of our torment. I think the psychosomatic medicine will be outlawed in the future just like nazism and psychologists and historians will retrospectivelly study our fate and everyone will ask how it was possible that mankind allowed this psychosomatic holocaust.
     
  19. JES

    JES Senior Member

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    It doesn't help our case to bring out the Nazi card. Yes the CFS/ME patients are victims and it is happening for longer than Auschwitz, but the similarities end there. I still have the freedom to do whatever I want or able to and see whatever doctor I can, plus try any of the off-label treatments. Even if you removed all psychosomatic models from medicine tomorrow, the CFS/ME patients are still going to be sick.

    If Wessely retracted all his statements and papers on CFS/ME tomorrow, it wouldn't change my daily life very much. The rare doctor that is aware of CFS/ME at all in my country would tell me "go home, there is no cure" instead of telling me "you might want to try some CBT". Neither one is of any help to me.

    Oh and this article of the topic was really poor, I plan to email the authors my rebuttal.
     
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  20. lilpink

    lilpink Senior Member

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