Keep Watching (February 26 blog post on NIH study and MUS)

[Dolphin]

http://spoonseeker.com/2016/02/26/keep-watching/

This blog post from February 26 discusses:

- the NIH ME/CFS study

- the weird way that the NHS (and other doctors) can approach medically unexplained symptoms, patients with multiple symptoms, etc.

If you have been following discussions about the NIH study closely, there may be little new in this.

Indeed, to judge from this NHS website here in England, there appears to be a presumption that any patient with multiple symptoms has a psychogenic condition. The page is about multiple symptoms, yet its title is ‘Management of Somatoform Disorders’. This gives the impression that the two may be considered synonymous.

 

[Chrisb]

As the NHS trust referred to is the North Bristol NHS Trust, no distance at all from Bath, one might almost be drawn to the conclusion that there is something about the water in the area.

 

[SilverbladeTE]

MUS is really short hand for

"Doctors without a fucking clue what's wrong, but can't admit it as that would dent their ego and pretence at omniscience, so blame the patient, as usual"

or

"Medicinae Uninformed Shitheadius"

 

[alex3619]

The two (MUS and psychogenic) are not synonymous, and highly rational arguments for that have been around for a long time. I have a bunch of blogs on this issue. Its just not rational to consider them synonymous, and brings justified doubt as to the credibility of anyone claiming it is. Irrational claims do not belong in science.

I have used this analogy before. I believe in UFOs. UFOs are real. There are lots of sightings, and unexplained events. Yet to treat UFOs as synonymous with flying sauces (or dragons or evil spirits or whatever) is reaching far beyond what we can currently prove. There is always the possibility that some UFOs might be alien ships or whatever (or time or dimensional travellers etc. etc. ) but we know a great many cases are eventually shown to be mistaken, and there is no definitive proof of flying saucers, though lots of claims are made.

As unproven hypothetical claims, potentially within the reach of science (but often treated unscientifically), psychogenic claims have merit. As anything even remotely proven they are universally a nonsense, at least at the moment. They are also a nonsense if they are too heavily into claims of mental rather than brain causation, and this is especially true over claimed monist viewpoints that are really disguised dualist viewpoints on theory of mind.

In short, psychogenic claims for MUSes are pseudoscience.

Its time for medicine to grow up, and past time.

 

[medfeb]

This NHS guide may be relevant to this.

Medically Unexplained Symptoms/ Functional Symptoms. (MUS/FS) 2014.
http://www.iapt.nhs.uk/silo/files/medically-unexplained-symptoms-postive-practice-guide-2014.pdf

The paper states that the "IAPT MUS Task and Finish group strongly advises that when engaging or treating patients, the term MUS is not used." and instead recommends "a specific diagnosis of a syndrome which describes their central symptom(s) without inferring that the aetiology is
psychological." Listed syndromes include FM, CFS, etc.

Recommends CBT and GET based on the biopsychosocial model for all

Members of the IAPT Medically Unexplained Symptoms Evaluation Task and Finish Group include Moss-Morris and Chalder. White provided input.