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Archives of Epidemiology & Public Health Research
The Rise and Fall of the Psychosomatic Approach to Medically Unexplained
Symptoms, Myalgic Encephalomyelitis and Chronic Fatigue Syndrome
David F Marks, Email: dfmarksphd@gmail.com
Submitted: 06 Dec 2022; Accepted: 12 Dec 2022; Published: 26 Dec 2022
The Rise and Fall of the Psychosomatic Approach to Medically Unexplained
Symptoms, Myalgic Encephalomyelitis and Chronic Fatigue Syndrome
David F Marks, Email: dfmarksphd@gmail.com
Submitted: 06 Dec 2022; Accepted: 12 Dec 2022; Published: 26 Dec 2022
The psychosomatic approach to medically unexplained symptoms, myalgic encephalomyelitis and chronic fatigue syndrome (MUS/ME/CFS) is critically reviewed using scientific criteria. Based on the ‘Biopsychosocial Model’, the psychosomatic theory proposes that patients’ dysfunctional beliefs, deconditioning and attentional biases cause or make illness worse, disrupt therapies, and lead to preventable deaths. The evidence reviewed suggests that none of these psychosomatic hypotheses is empirically supported. The lack of robust supportive evidence together with the use of fallacious causal assumptions, inappropriate and harmful therapies, broken scientific principles, repeated methodological flaws and an unwillingness to share data all give the appearance of cargo cult science. The psychosomatic approach needs to be replaced by a scientific, biologically grounded approach to MUS/ME/CFS that can be expected to provide patients with appropriate care and treatments. Patients with MUS/ME/CFS and their families have not been treated with the dignity, respect and care that is their human right. Patients with MUS/ME/CFS and their families could consider a class action legal case against the injuring parties.
(Document attached.)Review Article
1. INTRODUCTION
This review concerns a story filled with drama, pathos and tragedy.
It is relevant to millions of seriously ill people with conditions
that have no known cause or cure.1 Effective care for such
patients is almost zero, with bed rest, hope and prayer being the
only safe remedies. The drama began in Los Angeles in 1934
when an outbreak of 'epidemic neuromyasthenia' hit the news
[1]. Similar outbreaks occurred in many other places: Iceland,
South Africa, Australia, Switzerland, Denmark, and London. No
medical solution has yet been forthcoming, and patients continue
to suffer. Their tragic story is yet to be taken seriously and
waiting to be told. This review is dedicated to them. The focus is
the psychosomatic approach of psychiatrists, psychologists and
others within the ‘psychosomatic school’ (PS).