Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Populat

[floydguy]

Personally I think it's time to drain the swamp (as Rummy might say) and work towards getting CDC funding slashed. Clearly they aren't helping anyone and just wasting money and creating needless empires and kingdoms. They should be investigated by the Inspector General and perhaps become the focus of entities like Citizens Against Government Waste.

We should remember that the CDC really exists to prevent pandemics and mass disease. At the heart of their organization is credibility. There must be confidence in the organization so that the sheeple will follow what the CDC tells them to do. If they lose their credibility they will be useless.

The powers that be won't tolerate the CDC's credibility getting trashed by something like CFS.

 

[muffin]

Proposed plan of action - please add/comment

Guys: We must respond to this "stupid as sin study" for one reason: the idiot doctors and public will read it and use it against us. Those with a brain in their head will see it for what it is: a vicious attack against the CFIDS sick by a sociopath and his followers. It's obviously piss-poor science but if one doesn't know or understand the whole situation they may be led to believe the garbage in this "study".

So we need an Action Plan to counter the damage that this garbage will do to us.

1) Several of you have agreed to write a measured response to the journal attacking point-by-point Reeves' statements. You guys know to cite and cite like crazy. A smart person went and found those three other articles that refute how crazy CFIDS people are and they should be cited in the study. Not only do those three studies counter what Reeves says, but shows that this little group of nuts did not do any real scientific research - they just threw this crap together from other documents to attack us. Those responding to the study might ask/demand/request that this study be retracted due to its lack of scientific failures/methodologies, etc. (or whatever words work to that affect)

2) We do need to email the following people and demand that Reeves retract this article since it was written under the CDC label. Also, we need to demand that Reeves be retired from the CDC. Again, calm, measured reasons for why Reeves must be dismissed/retired from the CDC.
Several months after Reeves was moved to the Shrink side of the house I emailed Frieden and told him that Reeves needed to be retired and gotten out of the CDC because of the damage he was GOING to do to both the CFIDS sick and the CDC (and their credibility and reputation). Well, this study is proof enough that Reeves is making the CDC look foolish and Frieden needs to get Reeves OUT of the CDC NOW. We all got Reeves removed from the CDC/CFS program but now he is in a better position to really make us look like nuts. So, time to email like crazy and demand that Reeves be retired/dismissed, etc from the CDC now. That study should be enough proof that Reeves is now an old, demented, vindictive sociopath. If Frieden can't see that, well, there is no hope for the CDC.

I would put the study at the bottom of the email so that the person reading the email knows what we are talking about. I have already emailed these people but it would be a much bigger bang if we ALL emailed and complained about the study and Reeves. Fill up those mailboxes and force them to see what the current crisis is with CFIDS and Reeves.

- Thomas R. Frieden, (CDC Director) ftdh@cdc.gov
- Kathleen Sebelius, (HHS, owns the CDC) Kathleen.Sebelius@hhs.gov

3) I did email Elizabeth Unger yesterday and told her that the CDC/CFS website was her responsibility and it needed to be cleaned up. Probably a waste of time since I would bet she's hiding in her office or a broom closet and praying for her retirement date to arrive. But hey, email her if you think it might help or if you want to vent. Be constructive though.

4) I would NOT make this study public, as Tina pointed out. This stupid study should only be provided to other CFIDS/ME Advocacy orgs so that they too can hit on the CDC. But don't let this study go out into the public where it can be picked up and used against us by idiots. And, if you do see it in an article or blog, respond about how poor the study is and give reasons (see the many outstanding reasons you all wrote about on this thread). Reeves and his band of morons actually made up terms to use, which just blows me away. Attack the methodologies, the contradictions, and refute with the studies that show the CFIDS sick are actually more sane/stable than the general population, etc.

5) I have made it a point to discredit the entire CDC and not just the CFIDS side. Where possible, I have gone after the hyped Swine Flu and the huge waste of money on the research and the now wasted vaccines (over $500Million worth of vaccines destroyed in the US alone). I hate it, but I do think discrediting the whole of the CDC helps the CFIDS cause. There is a huge amount of waste at the CDC and many, many journalists are going after them for that alone. Point out the lack of credibility that the CDC has with the American public. Sucks, but it is true and it does help further damage anything that comes out of the CFIDS side. (I really would rather see the CDC fixed, but that's not happening with Frieden, yet).

Ideas??? You all know we MUST respond and respond NOW. This was Reeves last parting shot at us for giving him so much grief over the years and then getting him removed from the CDC/CFS program. This move prob. did not help his reputation or his sick little ego. So, this is how he is going to attack us and get even. Reeves really is a vindictive sociopath and he needs to be removed from the CDC.

I do think we have to go forward with some sort of legal actions against the CDC and maybe even DHHS. We need to find an attorney who will take on a class action against the government (and/or) individuals within the government for deliberate malicious malfeasance or whatever the correct legal terms are. I fervently believe we have to do this. I believe that JustinReilyESQ was looking into this but if others with lawyer family members (or legal backgrounds) could also see what can be done, that too would be great. I think we do need to bring some sort of legal action to force the CDC to show their documents/data and to bring this whole thing to the attention of the public.

(As an aside) I am not just talking about CFIDS but the Retroviruses that have been discovered by Defrietas and by Mikovits (and others) and covered up by the CDC and then funding removed for 30 years by the CDC and NIH. IF those Retroviruses are indeed as deadly as we/I believe them to be, then the public (US/Worldwide) MUST know about them and force action to be taken. In my guts I believe that XMRV and the other retrovirus(es) may be the cause or a large part of the cause for many different cancers and other diseases. And the CDC/NIH/HHS allowed them all to be out in the public and in the blood supply and blood products for over 30 years. This is a real travesty to everyone. I play this part up big time.

Sorry about the disjointed writing above. One of my dogs jumped on me this morning and woke me up before my brain was ready to be gotten up. I know you guys are super smart and will understand the gist of what I am trying to say. Please, make comments and also add to what you think must be done about this study. Again, I think we must respond hard and fast to this study before it does get into the public domain and do some very real damage to us. Idiots wrote the study and idiots will read and use the study against us.

I also sent Frieden and Sebelius the study that came out yesterday on XMRV being considered contagious to humans. I put that study under the Reeves study to show how real science is working versus psychobabble by a demented sociopath. Now that positive study with hard science IS what I would go very public with and spread around the internet. A deadly virus contagious to humans? That is a terrifying situation and one that the media and public would seize upon. I leave out the CFIDS part and just concentrate on the fact that there is a very deadly and contagious virus out in the public and in the blood supply and that 1 in 14 people are carriers (can not remember where I saw this 1 in 14 number).

Enough rambling from a tired chick. Thoughts please?? Super smart people please correct me and/or add - I don't have a brain anymore.

 

[Greggory Blundell]

Sorry if I missed this earlier, but has the CAA decried this "study"yet? I agree with muffin that we must each speak out with emails, but if our own advocacy organization does not strike back in our name and for our cause and against this sinister nonsense, then I fear our credibility is diminished.

 

[taniaaust1]

Twenty-nine percent of the CFS cases had at least 1 personality disorder

Wow.. i bet they were highly disappointed at that result. 29% of those who have a serious illness ending up with a personality disorder, isnt a large amount.

i myself ended up with borderline personality disorder due to something the ME (XMRV?) has done with my brain or how others have traumatised me due to it.. umm probably due to trauma due to the stupid things the CDC puts out there which influences doctors and the public to be bias and negative towards us. (i've been away last couple of days due to the BPD which ended up putting me into a hospital stay again, i made a mess of my arm). How many of us have now got things like BPD (which many think is caused by invalidation and abuse) or post traumatic stress disorder DUE TO the CFS!!

Pathetic study from the CDC, just the kind of thing I expected from them. Wasting the CFS studies funding once again. They should be held accountable for wasting CFS funding monies and held accountable for how they are making others treat us and hence the mental issues some of us THEN end up with.

Could the CDC be sued for the issues the crap they put on their site is causing to patients??

 

[muffin]

I also do agree that the tiny $3Million that the CDC gets for CFIDS needs to be removed from them. The CDC should have nothing further to do with CFIDS at all and in any way. IF the CDC wants to believe that CFIDS is a mental condition then it does NOT belong at the CDC, right? No sense in tracking or dealing with a mental condition. So if Reeves wants to play that game with CFIDS at the CDC, then maybe we should demand that CFIDS research be removed from the CDC. Recognize the consequences of removing CFIDS from the CDC - other Federal orgs might follow and other damage may be done to CFIDS. However, at this point the emphasis is on Retrovirus research - for cancers, diseases and CFIDS. That may make up for the loss of CFIDS at the CDC and other federal health orgs. Might. Don't know.

Again, I do believe that Reeves did everything possible to kill off funding for CFIDS real research to hide huge damage. I do believe he expected the budget and research to hit ZERO by the time he retired and then the CDC and other Federal health organizations would not bother anymore with CFIDS. If you aren't bothering with research on something it no longer exists and what ever you are concealing will be concealed forever. Let's look at the UK document that has been locked down for 83 years? What does that tell you? It means that the document and the damaging info it contains will be closed until Reeves, Weasel, White, Sharpe and others involved are long dead and we are dead and can't do a thing about what ever all they have been up to for three decades. The public needs to know about this situation as well. Paranoia does not enter into this one, does it?

 

[Dolphin]

1) Several of you have agreed to write a measured response to the journal attacking point-by-point Reeves' statements. You guys know to cite and cite like crazy. A smart person went and found those three other articles that refute how crazy CFIDS people are and they should be cited in the study. Not only do those three studies counter what Reeves says, but shows that this little group of nuts did not do any real scientific research - they just threw this crap together from other documents to attack us. Those responding to the study might ask/demand/request that this study be retracted due to its lack of scientific failures/methodologies, etc. (or whatever words work to that affect)

Note: if people want everything (or most things) challenged point-by-point, there could be need for more than one letter. It might be hard to get everything into one letter.

 

[muffin]

Sorry if I missed this earlier, but has the CAA decried this "study"yet? I agree with muffin that we must each speak out with emails, but if our own advocacy organization does not strike back in our name and for our cause and against this sinister nonsense, then I fear our credibility is diminished.

Sorry to Cort, but...I have no use for the CAA. They really are reporters as somone noted and not true advocates. They react instead of going on the offensive. What has been accomplished at Congress for any funding or investigations into the CDC and CFIDS/Retroviruses? Nothing. So, I expect nothing of value from the CAA and know that WE SICK must be the ones to fight our own fights now. Do not bother or look to the CAA, they can't or won't help. I'm sorry to say this since they really were a great group years ago, but not now.

WE MUST FIGHT our own battles now. Don't wait for others to fight for you. Won't happen. So, get mad and start thinking, writing, researching, etc.

 

[Dolphin]

The CDC and GET, CBT and compliance

As I have observed before, the CDC CFS team seem to have been taken in that GET and CBT are the treatment strategies to recommend at this time.

In this paper, they link the findings with personality disorders and bring up the issue of compliance.

I think this is potentially risky as the treatments are potentially risky. It might mean more pressure is put on patients to do GET and CBT and patients are listened to less if they are non-compliant.

============
Compliance and CBT/GET

From abstract:
This might be associated with being noncompliant
with treatment suggestions, displaying unhealthy behavioral
strategies and lacking a stable social environment.

Discussion

[..]

Persons with higher scores in neuroticism are
more likely to be noncompliant with treatment suggestions,
display unhealthy behavioral strategies, lack a stable
social environment and are therefore prone to illness.

[..]

Also, decreased
agreeableness and conscientiousness scores were found
in CFS. Both personality traits might affect compliance
with treatment regimes.

[..]

Although we found that personality disorders and
maladaptive personality features were relatively common
in persons with CFS, more than 70% of our CFS sample
did not fulfill the diagnosis for a personality disorder.
Clearly, persons suffering from a comorbid personality
disorder might need special attention when being treated.
For example, cognitive behavioral therapy and graded
exercise therapy are widely held to be the most effective
treatments for CFS although their results are inconsistent
[29] . Such therapies require that patients understand, adhere
to and practice specific activities to manage their
thoughts and expenditure of physical energy. The maladaptive
personality features that we describe interfere
with the ability to follow directions and maintain the selfmotivation
needed for cognitive behavioral therapy and
graded exercise therapy to be effective. Our findings suggest
that a successful treatment of persons with CFS may
require special attention to address maladaptive personality
therapeutically. Further, maladaptive personality
features might further the risk of negatively affecting the
doctor-patient relationship by their interference with the
patients motivation to attain by self-care a long-term adaptation
of their lifestyle and life goals.
Might those with certain personality disorders respond
differentially to different treatment regimes? Does
the presence or absence of a personality disorder have
implications for the prognosis or risk? How can this information
be used for the treatment of CFS? Should a
measurement of personality be included in a comprehensive
assessment of CFS [30] ? These are crucial questions
that need to be addressed in future studies of personality
and CFS. It is therefore important to consider our findings
when conceptualizing a treatment regime for individuals
with CFS. Our results indicate high correlations
between personality traits and illness domains. Similarly
high associations were found in the well and ISF groups.
This means that there is indeed a strong association between
personality and the experience of symptoms and
feelings of impairment; however, this is not specific to ill
people.

 

[muffin]

Note: if people want everything (or most things) challenged point-by-point, there could be more than one letter. It might be hard to get everything into one letter.

Agree Dolphin. You and someone else (can't remember who, but a great thinker/writer like you) should write the first response. Actually, could you please write the first response? Then we do need more outstanding, well researched/cited and written letters that back up your letter and also cover what ever else you left out. But, the first letter must be strong and hit hard in ways that can not be refuted.

So, who else is up to the task for writing a letter to this journal on this study? Those with a strong science/medical background or understanding would be most valuable. I do think that many good points have been made in this thread so we can grab and use many of those as well.

Help!?!?! Who else will step up and write a strong response???? I think we need a number of powerful letters.

I am NOT going to respond to this study as I fear messing it up. I think our best and brightest must take the lead on this. People like me can scream and email but I can not and should not respond to things like this that really require serious analysis and writing. I just can't do this type of analysis anymore. sucks.

 

[Dolphin]

There is no mention whatsoever of this study in the paper.
CFS isn't really that active an area in terms of the number of studies that are published. This paper appeared on PubMed Nov 2008. I think it should have been mentioned.

A previous CFS study which found a rate of 12% (same as controls)

Full text free at: http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0812C&L=CO-CURE&P=R474&I=-3

Chronic fatigue syndrome and DSM-IV personality disorders

J Psychosom Res. 2009 Jan;66(1):13-20. Epub 2008 Nov 22.

Courjaret J, Schotte CK, Wijnants H, Moorkens G, Cosyns P.

Department of Psychiatry, University Hospital Antwerp, Edegem, Belgium. kim.courjaret@uza.be

Abstract

OBJECTIVE:
Personality is an important factor in the research of the chronic fatigue syndrome (CFS).

Although some studies report a high rate of personality disorders--around the 40% level--in samples of patients with CFS, the generalizability of these findings can be questioned.

The present study evaluates the prevalence of Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) personality disorders in a sample of female CFS patients and in two control groups.

METHOD:
The ADP-IV questionnaire (Assessment of DSM Personality Disorders IV) was used to assess the DSM-IV-TR personality disorders at a dimensional and categorical level in a sample of 50 female CFS patients and in two matched control samples of Flemish civilians (n=50) and psychiatric patients (n=50).

RESULTS:
The results indicate a striking lack of statistical significant differences between the CFS sample and the Flemish control group at the level of dimensional Trait scores, number of criteria, and prevalence rates of personality disorder diagnoses.

Unsurprisingly, higher scores at these levels were obtained within the psychiatric sample.

The prevalence of an Axis II disorder was 12% in the Flemish and CFS samples, whereas the psychiatric sample obtained a prevalence of 54%.

CONCLUSION:
The prominent absence of any significant difference in personality disorder characteristics between the female Flemish general population and the CFS samples seems to suggest only a minor etiological role for personality pathology, as defined by the DSM-IV Axis II, within CFS.

 

[Tammie]

"They invented a personality disorder for this, too.....there is no such thing as depressive personality disorder in the DSM!!"
The Merck manual lists "depressive personality," as a personality type but says that it is not considered a disorder. Merck describes it as

"Depressive Personality: This personality type is characterized by chronic moroseness, worry, and self-consciousness. People have a pessimistic outlook, which impairs their initiative and disheartens others. To them, satisfaction seems undeserved and sinful. They may unconsciously believe their suffering is a badge of merit needed to earn the love or admiration of others. "


Sorry, I don't qualify; it's my optimism that tends to get on people's nerves. Pollyanna, and all that. Little Merry Sunshine. I try to temper it.

Well, besides the fact that Merck does not list it as an actual disorder, the CDC "study" stated clearly that they took the personality disorders mentioned from the DSM and as I said, it's NOT in there!....and they also clearly stated that the instruments they used to measure these disorders were based on the DSM, so again if they are not in the DSM, then the instruments could NOT measure this at all.

 

[Dolphin]

A few other random observations:

Reference 6 doesn't seem to be the correct reference.

The PDQ-4 was designed for high sensitivity at the expense of low specificity.

This suggests the instrument could lead to overdiagnosis.

Our findings are reminiscent of previous studies which
showed that almost 40% of CFS patients had at least 1
personality disorder [7, 8, 10] .

Unusual phrasing. And 29% isn't that near.

 

[Dolphin]

Agree Dolphin. You and someone else (can't remember who, but a great thinker/writer like you) should write the first response. Actually, could you please write the first response? Then we do need more outstanding, well researched/cited and written letters that back up your letter and also cover what ever else you left out. But, the first letter must be strong and hit hard in ways that can not be refuted.

So, who else is up to the task for writing a letter to this journal on this study? Those with a strong science/medical background or understanding would be most valuable. I do think that many good points have been made in this thread so we can grab and use many of those as well.

Help!?!?! Who else will step up and write a strong response???? I think we need a number of powerful letters.

I am NOT going to respond to this study as I fear messing it up. I think our best and brightest must take the lead on this. People like me can scream and email but I can not and should not respond to things like this that really require serious analysis and writing. I just can't do this type of analysis anymore. sucks.

Thanks but new voices might be better to write letters.

 

[Tammie]

Hi Dolphin,

I am talking about a proper letter to be published as a commentary. Let's talk. And anyone else who is interested.

definitely interested

 

[muffin]

Dophin is dead-on correct - there is a trend in what the CDC/CFS/REEVES is doing now

The CDC and GET, CBT and compliance -

They have a new strategy to nail us and we have picked up on where they are trying to go with this.
First change the website so the public/doctors can see the new stupidity that the CDC/CFS/REEVES are pushing. This includes the ultra dangerous GET and the worthless and wasteful CBT. Next, put out a study right after changing the website and tell people that the CFIDS sick are mentally ill, don't follow doctor's instructions (per their website), and rebelious, which when added to the mentally ill part makes us look like dangerous nuts. So, will the US follow the UK and put us all in psych wards instead of treating our very real illnesses and symptoms?

Before I forget- We also need to push to get the NIH and FDA studies published ASAP and without government intrusion (NO CDC/NIH damage to those documents). So, let's not allow these studies to fall away - push on getting them published until they are published with no instrusion/damage.

 

[muffin]

Tammie
View Profile View Forum Posts Private Message View Blog Entries View Articles Add as Contact

Senior Member

--------------------------------------------------------------------------------

Join Date:Sep 2009
Location:Woodridge, IL
Posts:590
Originally Posted by CBS
Hi Dolphin,

I am talking about a proper letter to be published as a commentary. Let's talk. And anyone else who is interested.
definitely interested

THANK YOU GUYS!!!!!!!!!!!!

 

[jspotila]

Do not bother or look to the CAA, they can't or won't help.

Muffin, I have a lot of respect for your enthusiasm, your persistence, and your fighting spirit. I also respect your right to your opinion. But I do have to say that comments like this do NOTHING to encourage the engagement of the Association with this message board.

Back on topic.

I was curious about the info at the bottom of the abstract that "Part of these analyses have been presented at the 67th Annual Meeting of the American Psychosomatic Society." I found the abstract book for the meeting here: www.psychosomaticmedicine.org/misc/abstracttext2009v2.pdf

Several interesting things stand out. First, the abstract presents data for CFS vs. well individuals. The 264 subjects with insufficient fatigue, including in the article, were not included here. This makes me wonder if that was one of the revisions required by the journal ("Received: August 9, 2009 Accepted after revision: January 5, 2010"). If so, this begs the question of why the authors selected the ISF group instead of the MS group from the 2003 study. Second, I added emphasis for the obvious question we've already asked: are the results of the study indicative of risk factors or the outcome of chronic illness.

120) Abstract 1747
THE ROLE OF PERSONALITY IN CHRONIC FATIGUE SYNDROME: FINDINGS FROM A POPULATION-BASED STUDY Urs M. Nater, PhD, James F. Jones, MD, William C. Reeves, MD, Chronic Viral Diseases Branch, Centers for Disease Control & Prevention, Atlanta, GA, Christine Heim, PhD, Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA

Purpose of study: Chronic fatigue syndrome (CFS) presents with unique diagnostic and management challenges. Insight into pathophysiology remains elusive. Maladaptive personality features have been discussed to be a risk factor of CFS or contribute to the maintenance of the disorder. No study so far has combined measurement of both dimensional (personality features) and categorical (personality disorders) approaches to personality in CFS. Methods: Study participants were identified from the general population of Georgia. A total of 113 cases with CFS and 124 well subjects participated in the current study. The NEO Five Factor Inventory (NEO-FFI) was used for the assessment of personality features neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). The Personality Diagnostic Questionnaire-4th Edition (PDQ-4) yielded personality diagnoses (PD) consistent with the DSM-IV diagnostic criteria for axis II disorders. In addition, the Multidimensional Fatigue Inventory measured facets of fatigue symptoms. Results: Comparing the NEO scales resulted in significant higher scores in the CFS group for N than in the well group. In E, differences were also significant, with lower scores in the CFS group. For A and C, well subjects had significantly higher scores than CFS. No differences were found for O. Importantly, N, but not the other dimensions, was correlated with the MFI scales general fatigue (r = 0.25), reduced motivation (r = 0.41), and mental fatigue (r = 0.52) in CFS (but not in well subjects). In addition, 29% of CFS cases had at least one PD (vs. 7% of well subjects). Most prominently, the two groups differed significantly in their prevalence rates for Paranoid PD (5.5% vs. 2.4%), Schizoid PD (6.4% vs. 1.6%), Avoidant PD (5.5% vs. 1.6%), Obsessive-compulsive PD (14.5% vs. 3.2%), and Depressive PD (6.4% vs. 0%). Discussion: Our results suggest that CFS is associated with increased prevalence of maladaptive personality features and PDs. It might be assumed that these persons are more likely to be non-compliant to treatment suggestions, display unhealthy behavioral strategies, and lack a stable social environment. The question arises whether personality dispositions are a premorbid risk factor or whether they are a consequence of the chronicity and severity of CFS. Future studies need address this important question.

There were two other abstracts on CFS presented at the meeting, and I've copied them below in case anyone is interested in those:

Abstract 1049
CHRONIC FATIGUE SYNDROME: ILLNESS SEVERITY, SEDENTARY LIFESTYLE, BLOOD VOLUME AND CARDIAC STRUCTURE AND FUNCTION Virginia T. Coryell, M.S., Barry E. Hurwitz, Ph.D., Meela Parker, CCT, RDCS, Pedro Martin, M.D., Psychology, Arthur LaPerriere, Ph.D., Psychiatry & Behavioral Sciences, University of Miami, Coral Gables, FL, Nancy G. Klimas, M.D., George N. Sfakianakis, M.D., Martin S. Bilsker, M.D., Medicine, University of Miami, Miami, FL
This study evaluated cardiac structure and function in Chronic Fatigue Syndrome (CFS) and non-CFS subjects, while controlling for CFS illness severity and sedentary lifestyle. In addition, we examined whether differences in total blood volume (TBV) could account for differences in cardiac outcomes. Study groups were: severe CFS (n=30), non-severe CFS (n=26), sedentary control (n=30) and non- sedentary control (n=30). Severe illness in CFS subjects was defined as >=7 of 10 CFS symptoms, self-rated as moderate or severe, that persisted for >=6 mos. Sedentary and non-sedentary physical activity status were defined, respectively, as a reported energy expenditure of <=1500 and >=2200 kcals/wk. Measures were obtained from self- report of medical history, fatigue and physical activity, as well as echocardiography and dual tag blood volume testing. Among potential covariates, group differences emerged for age and education, and hence were controlled in analyses. The analyses showed that the severe CFS group relative to the non-CFS groups evidenced diminished cardiac index (CI) due to diminished stroke index (SI; ps<.05) and not to heart rate differences. The diminished SI in the severe CFS group was due to lower end diastolic volume (EDV) and contractility (VCFc; ps<.05), with no group differences in end systolic volume. Follow-up analyses showed that the percent difference from ideal TBV was lower in the severe CFS group than the non-severe and sedentary-control groups (adjusted meanSE: -6.0%1.3 vs. -1.6%1.3 vs. 6.4%1.8; p<.001). When these TBV differences were controlled, the group differences in CI, SI, EDV and VCFc were no longer significant. Notably, the cardiac measures in CFS subjects did not correlate significantly with reported fatigue. Therefore, the findings suggest that although a cardiac function deficit is more probable in severely-affected CFS persons, it is not linked to sedentary lifestyle or perceived fatigue, but is largely accounted for by a deficit in blood volume.

227) Abstract 1305
IS THERE A LINK BETWEEN THERAPEUTIC OUTCOME IN CHRONIC FATIGUE SYNDROME AND COMORBID DEPRESSION? Boudewijn Van Houdenhove, MD, PhD, Liaison Psychiatry, Patrick Luyten, PhD, Stefan Kempke, MA, Psychology, University of Leuven, Leuven, Belgium
Purpose of study: Although it is assumed that chronic fatigue syndrome (CFS) and depression may show complex psychobiological links, there is a paucity of research investigating the role of comorbid depression in CFS treatment. Therefore, in this study the impact of comorbid depression on therapeutic outcome in a large sample of CFS patients was studied. Methods: Quasi-experimental, phase-lagged study of two multidisciplinary group treatment modalities with different intensity (weekly versus monthly), carried out in a tertiary care rehabilitation setting with two groups of CFS patients (n=101 and n=91 respectively). Both treatments were based on cognitive behavioural principles and also comprised relaxation exercises, pacing instructions and physical reconditioning exercises. Before treatment, comorbid depression was measured by the Hospital Anxiety and Depression Scale (HADS). Consistent with the recommended cut-off point for the HADS depression subscale in CFS patients (Morriss & Wearden, 1998), a score of 10 or more was used as a cut-off point to categorize patients as depressed versus non-depressed. Results: In both treatment modalities, therapeutic outcome was very similar. Moreover, in both conditions comorbid depression was negatively associated with outcome. For instance, taking the results of the two groups together, 49.1% (n=57) of the patients showing no improvement met criteria for depression, whereas only 26.3% (n=20) of the improved patients were depressed (chi square = 9.956, p <.05). Conclusions: These findings point to the importance of attending to comorbid depression in treating CFS patients and are in line with the advice to customize CFS treatment to individual patient characteristics (Van Houdenhove & Luyten, in press).

 

[SOC]

Has anybody read Tina's post at (post #91)http://www.forums.aboutmecfs.org/sh...their-desperate-cover-up!&p=106252#post106252

Well, I said I would let you know. I did talk to someone at the CDC, someone whose name is likely known by you guys, although I was not familiar until I looked up the name after the call.

But I find myself in an ethical dilemma. I am a reporter by trade. And in my work, I do not report on CFS issues. I am now just doing local fluff stuff for another newspaper. (As some of you know, I used to have my own, but had to close it.)

<snip> (Snipped, but very important, please read Tina's post in full before you act in any way on this info)

So, generally, their position is:
Yes, CDC considers ME to be different from CFS, no matter what others say. They are not studying ME. It would be difficult to find a knowledgeable doctor for ME in the US. There is no test for either one. A person should describe their symptoms to a doctor who can then look for underlying biological cause instead of going to doctor asking if they have a certain disease. Treat the abnormalities found to see if it eliminates the symptoms.

[my bolding]

We're getting all het up about this latest Personality Disorders paper (and rightfully so, in most respects), but the CDC is apparently planning to claim that they were never talking about us in this paper. Us meaning those with neuro-immune symptoms and signs of infection, those who were not included in their community based surveys......

 

[Tammie]

As well as the fact that this was done by the CDC, there is another reason unfortunately why it might be seen as particularly important: it is a random digit population study.
Other studies can be dismissed as not having unrepresentative samples.

Not that I really believe this is a representative sample of CFS patients - I think the empiric criteria (Reeves, 2005) are rubbish - but it can be quoted by others as a more definitive CFS study than others.

Actually if I am interpreting what you mean correctly, it is not so random as one might be led to believe......they chose an area of Georgia that was of low socioeconomic status and paid them to particapite if they reported feeling "unwell" for a month or more (so some incentive for one thing that could skew the results)....... & not to stereotype, but people living in the area where this was done are most likely stressed, possibly working more than one low paying job (so tired!), and probably not eating well or exercising a lot, not typically very healthy or mentally healthy, and not able to afford good health care or mental health care (like I said I don't like stereotypes, but these are some things that otehr studies have shown tend to be true of poorer socioeconimc status).....if this were actually random, they would not have limited it to this area of the population

 

[muffin]

Dolphin; It is a fair amount of work to refute but

We do have the points already in this thread, many of which YOU made.
I guess if I printed out this entire thread and copied/pasted the comments something might come together.

Please: We do need to respond to this study. Please everyone, step up to the plate and gin up a letter - not long - but STRONG and get it off to these people.

Also, bang on Freiden and Sebelius.

As for GAO, the Investigator Generals (IGs), I have emailed and filled out forms but nothing has come of it. Maybe if others added their requests to the pile something might be done.

We can not let the CDC get away with this. Now we have entered into a very deadly situation. Even when the positive XMRV studies come out, the CDC/CFS/Reeves/Weasel types will still find a way to damage us and put us into little boxes.