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Psychiatrists imaginary friends and chronic fatigue

Discussion in 'General ME/CFS News' started by Gerwyn, Mar 18, 2010.

  1. Gerwyn

    Gerwyn Guest

    This scenario could apply to a creator of certain english CFS guidelines I portray it as a psychiatrist talking to his imaginary friend and i have added translations to simplyfy the ramblings

    Ok guy we need a new definition here that suits us .We dont like the rules of this game so lets change thrm. I know Lets have a meeting and get a deug company to sponsor it

    We will start by just concentrating on fatigue of unknown cause but pretend we are nicey nicey

    Patients who present with a principal complaint of disabling fatigue of uncertain cause have received much attention in recent years

    The meeting (attended by all those listed at the beginning of the paper) was held at Green College, Oxford, on 23 March 1990, and chaired by Professor
    Anthony Clare. It was restricted to invited research workers, all of whom had studied patients with CFS
    Translation lets make sure the meeting is packed with our mates

    Before the meeting all participants (and several others who were unable to attend) were circulated with a questionnaire, and their responses used to
    draw up an initial discussion document which formed the basis of discussion during the meeting.

    Translation a meeting just with our mates may not be credible so we better use a qustionaire to get some other folks to voice their views

    Points on which agreement was reached were
    recorded and a draft of this paper circulated to participants

    Translation we ignore any dissenting voices.

    There are no clinical signs characteristic of the condition, but patients should be fully examined, and presence or absence of signs reported.

    Lets make sure no objective measurements are used we cant fiddle those

    Chronic fatigue syndrome (CFS)
    a) A syndrome characterized by fatigue as the principal symptom.
    b) A syndrome of definite onset that is not life long.
    c) The fatigue is severe, disabling, and affects physical and mental functioning.
    d) The symptom of fatigue should have been present for a minimum of 6 months during which it was present for more than 50% of the time.
    e) Other symptoms may be present, particularly myalgia, mood and sleep disturbance.
    f) Certain patients should be excluded from the definition. They include:
    ~ Patients with established medical conditions known to produce chronic fatigue (eg severe anaemia). Such patients should be excluded whether the medical condition is diagnosed at presentation or only subsequently.

    Translation we can exclude any patients that look dodgy later

    All patients should have a history and physical examination performed by a competent physician.

    Translation Lets not bother with blood tests after all we are competent physicians arent we.

    (i)Patients with a current diagnosis of schizophrenia, manic depressive illness, substance abuse, eating disorder or proven organic brain disease. Other psychiatric disorders (including depressive illness, anxiety disorders, and hyperventilation syndrome) are not necessarily reasons for exclusion.

    Translation lets include as many depressed patients as we can
    Post-infectious fatigue syndrome (PIFS)

    Reliable measures of subjective fatigue and of disability are lacking and require development. When reporting studies the reliability of all measures should be assessed and specified whenever possible.

    Translation we will define fatigue to suit ourselves

    (i) When used to describe a symptom this is a subjective sensation and has a number of synonyms including, tiredness and weariness
    Translation lets trivialize this as much as possible

    Two aspects of fatigue are commonly reported: mental and physical. Mental fatigue is a subjective sensation characterized by lack of motivation and of alertness. Physical fatigue is felt as lack of energy or strength and is often felt in the muscles.

    translationWe will define fatigue as caused by low motivation or something the patient feel in the legs or muscles implying it is psychological of course clever eh

    The symptom of fatigue should not be confused with impairment of
    performance as measured by physiological or psychological testing. The physiological definition of fatigue is of a failure to sustain muscle force or power output.

    Translation this is real fatigue we are not going any where near that

    Disability (eg inability to walk) should be distinguished from impairment of function (eg weak legs), and from handicap (eg unable to work).

    Translation this should keep the government and the insurance companies happy
  2. Mithriel

    Mithriel Senior Member

    That is so true. They define their terms so that at a quick glance they seem fine but they all have what you could term a strong meaning and a weak meaning

    i.e. fatigue can mean the complete exhaustion in a cancer patient or not feeling like getting out of bed and going to work on a Monday morning.

    They then proceed to use whatever weight of the meaning suits them but get support because others think they are using the strong meaning.

    Wessely's XMRV paper where he said his patients very sick so people equated them with the patients in the WPI paper is a case in point. He gave no objective measures but used a slippery term.

  3. jace

    jace Off the fence

    :Retro mad:Are you just a little bit angry:Retro mad: Mithriel? You have every reason to be:(

    Maybe though, in Dylan's words, 'The times they are a'changing'
  4. Angela Kennedy

    Angela Kennedy

    Essex, UK
    Hi Mithriel

    I addressed this point in my response to Wessely and his two colleagues, on the Plosone website (readers responses) following the Erlwein et al article being published there.
  5. Mithriel

    Mithriel Senior Member

    The replies were very good, you did well. :Retro smile:

    I've realised that I want to see the weasels brought down more than I want a cure - sad, but true :cool:

    I was a scientist once and I think that their crimes against ME are matched by their crimes against science. They have destroyed its integrity and left us with no answer to the people who are anti science.

  6. Gerwyn

    Gerwyn Guest

    that is almost the greatest tragedy of all the corruption of science second only to the wanton destruction of lives
  7. fingers

    fingers Senior Member

    SW Endland
    Sticky Poll

    Somebody help me, please.

    Has this happened because these people:

    A See a career/commercial opportunity and deliberately and corruptly steer things to this end?
    B Honestly believe that the prime drivers are psychological?
    C Just don't get it and need counselling themselves? (could be the same as B)

    View Poll results..............

    I think I'm getting close to having a dialogue with the lead (EC) in the study of the LP Process and children. I need to have my thinking very clear. All the input on this forum is helpful. However, simply beating these people around the head with counter arguments I don't believe will be productive.

    Any thoughts?

  8. starryeyes

    starryeyes Senior Member

    Bay Area, California
    That's creative gerwyn and sadly, reflects reality.
  9. jerrycam


    Pueblo, CO
    You would think that the medical establishment would learn after a few decades of making the same mistake over and over again.

    Back in the 50s, there was the epidemic of "hysterical paralysis" sweeping the country. Then Drs. Salk and Sabin developed a vaccine against the polio virus, and suddenly the "hysterical paralysis" disappeared.

    The same thing happened with the initial identification of MS. And post-polio syndrome. And probably dozens more that I don't know about - virtually everything that has fatigue as a major symptom; or neurological symptoms. All of these cases should be taught in med school. And it should be made clear that medicine does not have all of the potential pathogens neatly cataloged and specific tests made. But instead they are still teaching the "Doctor God" model, where "modern" mainstream medicine knows all.

    Equally unfortunately the psychiatrists seem to be in some considerable power (encouraged by insurance companies that have to pay for medical tests and treatment, but not psychiatric), and are always looking for groups of different, ill people, to ascribe a psychiatric cause to and proclaim themselves as the experts and the only treatment for that disease.

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