This is by Per Fink, a Danish psychiatrist.
I think most people won't like it.
He talks about death threats in other countries e.g. UK.
He mentions how the approach is recognised e.g. with the NICE guidelines for CFS/ME in the UK.
He talks about patients being prejudiced against CBT, GET and the like.
He claims Katrina Hansen isn't being treated involuntarily - which is news to me.
http://www.dagensmedicin.dk/opinion/debat/stig-gerdes-er-med-til-at-optrappe-konflikter/
http://translate.google.com/transla...stig-gerdes-er-med-til-at-optrappe-konflikter
I think most people won't like it.
He talks about death threats in other countries e.g. UK.
He mentions how the approach is recognised e.g. with the NICE guidelines for CFS/ME in the UK.
He talks about patients being prejudiced against CBT, GET and the like.
He claims Katrina Hansen isn't being treated involuntarily - which is news to me.
http://www.dagensmedicin.dk/opinion/debat/stig-gerdes-er-med-til-at-optrappe-konflikter/
http://translate.google.com/transla...stig-gerdes-er-med-til-at-optrappe-konflikter
Debate
Updated 06/06/2014 Opinion: Debate
Stig Gerdes helps to intensify conflicts
When a doctor stands out with violent and unsubstantiated attacks on researchers and practitioners who want to help patients with functional disorders, you are helping to create anger and misunderstanding.
We must ask care and conscientiousness.
Practitioner Stig Gerdes (SG) writes Dagens Medicin he until a year ago did not know anything about functional disorders, but after he had 'scratched the surface' wants investigation of the area with the aim to find out whether functional disorders scientifically substantiated or 'Emperor's New Clothes'.
If SG had set themselves a little better into things and not just 'scratched the surface', he would have learned that there is solid evidence.
In addition to textbooks, we published in the American Journal of Physicians in 2010, a status article in Danish, where SG can find the documentation. Since 2010, there have been several new review articles published in high-ranking journals such as JAMA and Lancet.
Danish College of General Practitioners has issued a clinical guideline for functional disorders, which also evidence levels are listed, and there are also foreign clinical guidelines, for example.
National Institute of Health in England for CFS/ME. Around treatment concludes these clearly show that there is good scientific evidence that cognitive therapy, graded rehabilitation and sometimes antidepressants can help patients with functional disorders, regardless of what name they are dealt with, for example, fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome/ME and bodily distress syndrome.
In recent years there has been a growing interest in functional disorders, and have led to several questions from various regulatory agencies. Research Clinic for Functional Disorders (FFL) has supplied evidence of a very large amount. This has never given rise to criticism from any authorities, and the many stories that abound especially on the Internet, has been found to be groundless.
It is noteworthy that the SG was invited for a parliamentary hearing on March 19 as an expert in functional disorders. SG seems to have only a sparse knowledge of the area and his main qualification seems to be some strong views, as expressed for example. with statements like 'functional disorders are a cancer that must be removed from the Danish healthcare system." There are several specialists in general medicine in Denmark, which has long scientific and clinical experience in the area, which would have been more appropriate.
SG claims that FFL has captive, forced detention and compulsory treatment a real young woman. This is a story that flourish especially in the social media, and in particular has enabled a group of American 'patient activists' who created an English-language Facebook group and want to free the woman.
As SG has been previously pointed out, the reference to and all processing on FFL voluntary, and no patients are involuntarily committed, forced detention and compulsory treatment.
People's Committee of Health has a § 71 committees that can take patient cases with the aim of ensuring that everything goes properly.
Committee secrecy and has access also to information that is subject to medical confidentiality. In the instant case, § 71 Committee visited and all relevant authorities involved and fully informed.
I find it problematic that SG publicly questioning that he should know that because of our confidentiality must not answer. I expect the SG as a doctor is aware that none of the involved authorities or professionals may comment on a patient without the patient's consent.
I find it unethical that SG helps to spread directly untrue stories about a specific patient, and the SG without the consent of the patient have established a group on Facebook where there is initiated a fund-raising will be used in an undefined trial for the patient against FFL.
I would like to appeal to the SG exhibits diligence. The patient will for years to come risk having to deal with these terrible and false stories where she hung out on the net, both with pictures and full name without having expressed a desire to become a publicly known person or consented to be referred to.
SG criticizes the fact that I know the parliamentary hearing was trying to show a patient case. I tried to play a public news reports, but because of technical problems failed. The feature was shown on TV2, which the patients had obviously been consented.
SG writes that patients with adverse events following HPV vaccination is likely to be diagnosed with a functional disorder. We do not do research in HPV vaccines, and we have not met patients who have had a functional disorder after HPV vaccination.
SG attaches me credit for the diagnosis of fibromyalgia is listed as a functional somatic syndrome. But it is not correct. The foreign researchers who should have the honor.
SG wonders that functional disorders encounter greater resistance than most other diseases. This is an international phenomenon that has been called 'patient activism' and is very strong example. U.S., UK and Norway. In these countries there are examples of doctors and researchers who have received death threats if they work with or speak favorably of treatments such. Cognitive Therapy and graduated rehabilitation.
The resistance stems from the stigma that patients with functional disorders unfortunately in some context are exposed. Patient activists are fighting against what they call 'psykiatrisering' and struggles that only research on 'biomedical' causal explanations for their illnesses.
In this fight, there is a lot of discrimination of mental illness, and the game is in some countries so aggressive that professionals and researchers get discouraged and choose not to deal with this disease group. Which goes beyond the large group of patients with functional disorders who want to appropriate treatment.
The resistance in Denmark is fortunately not quite as violent. But SG helps to escalate the conflict, anger and misunderstandings when he as a doctor publicly stand behind violent and unsubstantiated attacks on researchers and practitioners who want to help patients with functional disorders. Again, I would like to appeal to the SG exhibits diligence. For the only losers in this conflict are the patients.
We do not know the exact cause of functional disorders, and we look forward to the day when we learn more about them and can develop even better treatments. SG claims that American scientists are about to have found the cause of fibromyalgia, and it would be gratifying if that was the case, but I must be doubtful about this. As a research in the field, we follow the course of the literature review. Furthermore, there is currently a major study underway in the Board of Health on chronic widespread pain. I sit with the Working Group and we have not come across information that goes in the direction that SG specify.
SG is surprised that he has only met one patient who chose to stand up in the press. There are actually about 10-15 patients who over time have chosen to stand up and talk about their illness, but I would like to give SG right that to the ordinary newspaper reader, it will provide greater impact if more patients would come forward .
When there are no more, it has two main reasons. Firstly, there is a certain social stigma of patients with functional disorders. Many patients do not consider that example. friends, colleagues and employers are told that they have been ill with a functional disorder.
Second, some of the patients who have already made himself available to the press, seen to have very unpleasant mails and messages on Facebook from the Danish patient activists. Some of the patients have regretted their decision to come forward. In Norway, a patient with CFS/ME (chronic fatigue syndrome), which was recovered from psychological treatment, received death threats. It has none of the Danish patients received, but we are very aware of the risk. We hope that the SG and other professionals will put more emphasis on research than on individual patient stories in the press.
Finally, I would emphasize that we are working for a group of patients who have some very complex disease, and we want that patients with functional disorders get the same good treatment in our health care as everyone else. On a daily basis I experience some talented and dedicated employees and many grateful patients.
It's still a pleasure to work with and help patients with functional disorders, and when there are negative stories in the press or on the web, we find that both past and current patients to contact us with their support.
If SG or want more information about functional disorders, we have compiled both general information and our scientific articles on the website www.funktionellelidelser.dk.
In addition, you are always welcome to contact the department.
SOURCES
A. Schroeder, P. Fink, LO Fjorback, L. Frost Holm, E. Rehfeld, and M. Rosendal. Treatment strategy for functional syndromes, and somatization. Ugeskr.laeger 172 (24) :1839-42, 2010.
M. Rosendal, KS Christensen, L. Agersnap, P. Fink, and CV Nielsen. Clinical guidelines for general practice. Functional disorders, Danish College of General Practitioners, 2013.
P. Henningsen, S. Zipfel, and W. Herzog. Management of functional somatic syndromes. Lancet 369 (9565) :946-955, 2007.
DJ Clauw Fibromyalgia. A Clinical Review., MD April 16, 2014 Volume 311, Number 15
By Per Fink, PhD, MD. Professor, Senior Consultant Research Clinic for Functional Disorders Aarhus University Hospital
