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bmj - good and outrageous(bad) ME info


bmj - good and outrageous(bad) ME info aimed at doctors

Tom Kindlon put a reference to a fairly good article on bmj by Nancy Blake, UKCP Accredited Neurolinguistic Psychotherapist titled Suggestions for diagnosis of patients presenting with fatigue 29 October 2009 up on co-cure


I gather the website is to offer tips for gps to make good diagnoses. I thought it was a fairly good article (but would like to know how she is nearly recovered from ME). Included are

Straightforward diagnosis: If your patient feels better after exercise, he may be depressed. If your patient feels worse after exercise, he may have ME. ............

post-exertional malaise associated with ME ............

Symptoms vary from hour to hour and day to day, and make the patient sound like a raving hypochondriac, but the configuration of symptoms is very recognisable,...........

Because the level of disability present in ME (especially if a patient is forced, either by circumstances or by medical misjudgement, to exercise) is very expensive to pay for, insurers, and our government, have been willing to pay well psychiatric consultants prepared to testify that this is a psychiatric, rather than a medical condition. The 'effectiveness' of therapies such as CBT and GET is researched with funding which should be used for medical investigation, and based on studies which eliminate individuals who suffer 'post exertional malaise', but the results are then used to justify forcing these therapies onto people who have ME and can be severely damaged both by the assumptions implicit in treatment for 'faulty thinking' and by physical exercise. Hopefully further research on viral factors will discredit these approaches sooner rather than later.

The scary part is, Nov 1, this year, a response came from Karl C. Mayer, psychiatrist and neurologist Bergheimer Strae 56a, 69115 Heidelberg, Germany, trying to support ME/CFS as being a psychiatric illness!!!?????

A birth cohort study comes to the conclusion: "Individuals who exercise frequently are more likely to report a diagnosis of CFS in later life. This may be due to the direct effects of this behaviour or associated personality factors. Continuing to be active despite increasing fatigue may be a crucial step in the development of CFS." [5] Chronic fatigue syndrome has become a diagnosis that seems to do more harm than benefit. One study concludes: Poor outcome was predicted by membership of a self-help group and being in receipt of sickness benefit at the start of treatment. [6]

5. Samuel B. Harvey, et al., Etiology of Chronic Fatigue Syndrome: Testing Popular Hypotheses Using a National Birth Cohort Study Psychosomatic Medicine 70:488-495 (2008)
6. Richard P. Bentall et al., Predictors of response to treatment for chronic fatigue syndrome The British Journal of Psychiatry (2002) 181: 248-252

I find the last 2 sentences almost too outrageous to comment on. Theatre of the absurd:eek::eek::eek::eek::eek::eek:

Think I'm over my letter writing quota, but if anyone else is inspired............