Peter White/Barts - comments on draft NICE guidelines - insight into their views

[Mark]

No problem, Mark.

BTW, I have read some of your other messages on other threads over the last 24 hours and am a bit more at ease with where you are coming from, so I will try to ease off on some of the challenging. TC, Tom

Thanks Tom. I think I have consistently said that I didn't see any significant difference of opinion between us, and that all such things are relatively minor compared to the scale of what we have in common - what we have faced and what we may face next. I'm here to learn from others, so it's all good. The other threads you mention (The Psychiatric view of ME/CFS. What is it? and Peter White/Barts - comments on draft NICE guidelines - insight into their views) are indeed superb, packed with useful information I'm mining.

 

[Tammie]

The Wessely, White, Barts view of treating MCS is comparable to trying to treat a diabetic by increasing their sugar intake

 

[Dolphin]

We've seen their view on MCS.

It looks like light sensitivity is another thing that has been caused by a lack of exposure!

Title: Impact Assessment of EuP Implementing Measures for non-directional household lamps
Department: Department for Environment Food & Rural Affairs
Date: 1 Dec 2008

http://www.ialibrary.berr.gov.uk/uploaded/45. EuP Domestic Lighting_v2 5.doc

[..]

Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME)

SCENIHR noted that chronic fatigue syndrome is one of several names given to a potentially debilitating disorder characterized by profound fatigue which lasts for at least six months. People with chronic fatigue syndrome most often function at a substantially lower level of activity than they were capable of before the onset of illness. Patients report various nonspecific symptoms, including weakness, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional fatigue.
SCENIHR concluded that ” There is conflicting evidence regarding patients’ sensitivity towards light.”

One clinician, Professor Pinching26, indicated that the consistency of the stories about the adverse experiences of some CFS/ME patients with fluorescent strip lighting is enough to say there is a definite question to answer, but does not know the extent this relates to new low energy lighting. It is probably related to the distorted sensory processing that is a common part of the neurological effect of CFS/ME. Professor Pinching indicated that the issue is not just about the intensity of the light, but about the quality.

Another clinician Dr Maurice Murphy62 did not know of any evidence that demonstrates that CFLs or any other lighting has any effect, detrimental or otherwise, on CFS/ME. Some patients do indicate light sensitivity, but this could be part of a general hypersensitivity to various stimuli. Dr Murphy thought there may be a maladaptive response, for example patients confining themselves indoors then finding it difficult to adapt to brighter lighting. Proper evidence would require a controlled study but this would be difficult practically.

Professor White63 indicated that he would be surprised if radiation from low energy lighting had a detrimental effect on patients with CFS/ME, but would not be surprised if open studies supported such a relationship. This is because, for some patients, the knowledge that they were being exposed to radiation reported anecdotally to cause harm would be enough to cause such a reaction. Dr White was not aware of any studies to test a reaction to CFLs.

61. Action for M.E., 2008 http://www.afme.org.uk/ (accessed 3 Aug 2008).
62. information from Dr Maurice Murphy, ME/CFS service, St Bartholomew’s Hospital, London
63. information from Professor Peter White, Professor of Psychological Medicine, Barts and the London School of medicine and dentistry, St Bartholomew’s Hospital, London.

 

[Dolphin]

As I recall, Maurice Murphy used not to be that bad when Pinching was in Barts.

Now, he just seems to go along with Peter White:

Letter published in The Times (UK) (Sept 2008)

Sir, While we have sympathy for Ms Patten's plight, research shows that a
significant minority of people with CFS/ME can recover with treatment, and
the majority improve.

The National Institute for Health and Clinical Excellence guidelines,
published last year, were based on the largest ever systematic review of the
management of the illness, and recommended rehabilitative treatments, such
as cognitive behaviour therapy, and graded exercise therapy as safe and
effective.

Although CFS/ME can be triggered by some infections, there is no reliable
evidence of persistent infection, and the heart and cardiac function are
normal, apart from the effects of deconditioning. To the best of our
knowledge, no patient has ever died directly as a result of CFS/ME and
follow-up studies show no increased risk of dying.

Yes, more research is needed to understand the illness, but both access to
currently available treatments and realistic hope for recovery are equally
important.

Professor Peter White
Dr Maurice Murphy
St Bartholomew's Hospital, London

-----------

 

[Dolphin]

A video of a talk by Prof Peter White, What is Chronic Fatigue Syndrome, What is ME?

This is from April 2008 but I've seen no evidence he has changed his views. He used similar slides when speaking in Bergen, Norway recently:

http://www.rsm.ac.uk/academ/video.php

http://rsm.mediaondemand.net/playersp1.aspx?EventID=1291

 

[MEKoan]

Just a gentle reminder to any who feel that they needn't be too concerned because he is on the other side of the pond, Dr White is given a rousing endorsement by the CAA.

 

[Dolphin]

Hello TomK,



Thanks for the links. I haven't looked yet, and if it involves talk I am out for the moment, alas, since the only computer I can use doesn't do sound for the moment.

But I wouldn't mind a serious look on my part into their tales and presentations. It is definitely a rot of lot, and I think I can show so too, in effective satire also. What I am interested in for the moment is a written summary of his case, and also one by Wessely and one by Sharp, also accessible on the net, without payment.

Hooper on Wessely

- http://www.meactionuk.org.uk/SELECT_CTTEE_FINAL_VERSION.htm

is excellent stuff though, except that it is too long and too technical for most, unfortunately, and it - or the version I saw - also ought to be somewhat better formatted. But Hooper knows his methodology and philosophy of science, and Wessely doesn't. I do. (Part of his trickery is from the blarney schools of philosophy though.)

It will be interesting and enjoyable to grind their pseudo science into little bits, so if you can fuel me - see above - I'll be glad of links.

You could have a look at the thread at: http://forums.aboutmecfs.org/showth...ors-on-CFS-organised-by-CBT-School-of-Thought where some insightful observations were made.

 

[helsbells]

I am, as always, so grateful that people take the time to post as I attend Barts already and was thinking of asking for a referal to Dr Maurice Murphy as I noticed he was an immunologist rather than psychologist. It seems I will save my time and not open myself up to further abuse by the establishment!!

 

[justinreilly]

Thanks Orla,
I have fun posting one star reviews on Amazon when I encounter nonsense like this.
Anyone care to join me? http://www.amazon.com/Kumar-Clarks-...dp_top_cm_cr_acr_txt?ie=UTF8&showViewpoints=1

If you enjoy writing your own excoriating review, check out my Amazon page for suggestions on other books to ridicule.
http://www.amazon.com/gp/cdp/member..._pdp_rev_all?ie=UTF8&sort_by=MostRecentReview

 

[Dolphin]

Thanks Orla,
I have fun posting one star reviews on Amazon when I encounter nonsense like this.
Anyone care to join me? http://www.amazon.com/Kumar-Clarks-...dp_top_cm_cr_acr_txt?ie=UTF8&showViewpoints=1

If you enjoy writing your own excoriating review, check out my Amazon page for suggestions on other books to ridicule.
http://www.amazon.com/gp/cdp/member..._pdp_rev_all?ie=UTF8&sort_by=MostRecentReview

As many people will know with Amazon, people can say whether they found Justin's reviews helpful or not. :Retro smile:

 

[Dolphin]

Peter White on video

(I just posted a similar post to this on another thread but thought people who have followed this thread might find it of interest)

If anyone is interested, one can see Peter White.
http://www.rsm.ac.uk/academ/video.php
under Chronic Fatigue Syndrome 28th April 2008.

I've attached the slides to go with the talk.

 

[Gerwyn]

Hello Tom,

Thanks very much for this reference:



Being a psychologist myself I strongly recommend this, and can add that the Conclusion of thuis article that I now quote in part, is the conclusion I reached myself in 1980



After editing this: The part after "(..)" and the text I wrote below it went to bitheaven, without leaving a trace.

Anyway: This is a fine article, that I strongly recommend. (There is some real science done in psychology, though, and even in psychiatry, but it is minority stuff, often also by people with some better education than psychologists get.)

Also, I am quite certain that Wessely, Sharpe and White KNOW this stuff, and indeed trade on it: Few psychologists and few medical doctors have a good understanding of statistics, and what they know of methodology or philosophy of science is usually fit for incantantions only.

This is also why so called "Evidence Based Science" is more an icon or a mockery than real science, in psychology, psychiatry, and also in a considerable amount of "evidence based medical science", it would seem, and especially so in the hands of the Bleijenbergs, for the pseudo-scientists in psychology and psychiatry have learned how to dress up a text AS IF it is based on solid methodology and statistics, although they rarely really understand it, and they also have learned - Wessely has, for certain - how to use the doubletalk and trickery that is part and parcel of "hermeneutics", "postmodernism", "interpretation" etc. in phoney modern philosophy.

Ah well! Thanks very much for finding this excellent article. I strongly recommend it to anyone who believes psychologists or psychiatrists "must be" or indeed "know" *real* science: Most of those I know or read in these so-called sciences don't, and that is a REAL problem, since pseudo-science only helps pseudo-scientists, and no one else.

MM

Some of us do! If it wasn,t for psychologists the workings of the mind would still be largely unknown . We would still not understand how a mind is formed without that understanding re causation these so called psychiatric problems cannot be resolved.There is a lot of rubbish in psychology mostly as a result of sociological infiltration but the work of Shore, Segal Stern and Bowlby put the study of mental health firmly in the field of scientific endevour--The days of Psychiatrists are numbered if they dont adapt
Nice to here from you neurocognitive psychologists inhabit a different planet to the psychoS

 

[Dolphin]

Bowel symptoms

Peter White/Barts Chronic Fatigue Service claimed the following

(v) Bowel symptoms and CFS/ME:

Draft text:
6.4.5.5 Prescribing of gut anti-spasmodics (such as mebeverine,
alverine, and peppermint oil) should be considered for adults and
children with bowel symptoms, such as cramp or bloating.

SH St Bartholomew's Hospital Chronic Fatigue Services
85 FULL 229 6.4.5.5
"..gut anti-spasmodics.." are not
treatments of CFS/ME since bowel
symptoms are not part of CFS/ME. You
should make it explicit that this
treatment might be indicated for the
treatment of IBS, if present comorbidly.
Alternatively, and perhaps more wisely,
you could suggest that IBS, if present,
should be treated in the light of the best
available evidence, and refer readers to
appropriate guidance, which may or
may not include considering
antispasmodics as the treatment of
choice for "bloating", although we would
doubt it. You do mention IBS on page
233, line 12.
NICE:
We have revised this
recommendation and referred to the
NICE IBS guideline – currently in
development.

=====================

However a series of papers on patients who had Giardia shows that patients can have bowel symptoms as part of post-infectious fatigue syndromes (you only really need to read the first one):

High rate of fatigue and abdominal symptoms 2 years after an outbreak of giardiasis.

Mrch K, Hanevik K, Rortveit G, Wensaas KA, Langeland N.

Trans R Soc Trop Med Hyg. 2009 May;103(5):530-2. Epub 2009 Jan 30.

National Centre for Tropical Infectious Diseases, Haukeland University Hospital, 5021 Bergen, Norway. kristine.moerch@helse-bergen.no

The aim of this study was to evaluate the prevalence of fatigue and abdominal symptoms 2 years after Giardia lamblia infection. All 1262 cases who had Giardia-positive stool samples during an outbreak in 2004 in Norway received a questionnaire in 2006 asking about fatigue and abdominal symptoms. Fatigue was reported by 41%, whereas 38% reported abdominal symptoms, and there was a highly significant association between these symptoms. Increasing age was a highly significant risk factor for fatigue. The symptoms were not due to chronic infection in this cohort. Our data warrant further investigations into the late effects of giardiasis.

Here are the exact figures*

We have previously reported a highly significant association between fatigue and abdominal symptoms in this cohort; 66% of the cases with fatigue reported abdominal symptoms

*I don't have the full paper but it was mentioned in http://www.biomedcentral.com/imedia/2188514913091934_comment.pdf in Pre-publication history http://www.biomedcentral.com/1471-2334/9/206/prepub
of "Severity of Giardia infection associated with post-infectious fatigue and abdominal symptoms two years after"Kristine Mrch , Kurt Hanevik , Guri Rortveit , Knut-Arne Wensaas , Geir
Egil Eide , Trygve Hausken and Nina Langeland BMC Infectious Diseases 2009, 9:206doi:10.1186/1471-2334-9-206

Effects of albendazole/metronidazole or tetracycline/folate treatments on persisting symptoms after Giardia infection: a randomized open clinical trial.

Hanevik K, Mrch K, Eide GE, Langeland N, Hausken T.

Scand J Infect Dis. 2008;40(6-7):517-22.

Department of Medicine, Haukeland University Hospital, Bergen, Norway. kurt.hanevik@helse-bergen.no

After an epidemic of giardiasis, some patients experienced persisting abdominal symptoms despite becoming Giardia-negative in stool samples after metronidazole treatment. The study aimed to determine if these patients were suffering from treatment refractory, chronic, cryptic giardiasis. The design was a prospective randomized open clinical trial with 1 arm receiving anti-Giardia treatment in the form of albendazole and metronidazole (A/M) for 7 d (n=12) and the other arm receiving tetracycline and folic acid (T/F) for 28 d (n=13). Symptom scores and global improvement were outcome measures. Symptom scores were analysed regarding time and treatment using mixed linear modelling. In both groups total symptom scores improved at the end of treatment; the improvement was significant for the T/F group. Bloating decreased significantly in both groups at the end of treatment. One month after treatment, 3 patients in the T/F group (23.1%) and 1 patient (8.3%) in the A/M group reported global symptom improvement. Symptoms recurred in all of these, and after 1 y total symptom scores were unchanged from baseline in either group. Treatment of post-giardiasis persistent abdominal symptoms with T/F or A/M resulted in only temporary symptom relief, possibly due to the anti-inflammatory effect of both treatments. Cryptic chronic giardiasis was not the explanation for the persistent symptoms.

Persisting symptoms and duodenal inflammation related to Giardia duodenalis infection.

Hanevik K, Hausken T, Morken MH, Strand EA, Mrch K, Coll P, Helgeland L, Langeland N.

J Infect. 2007 Dec;55(6):524-30. Epub 2007 Oct 26.

Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway. kurt.hanevik@helse-bergen.no

OBJECTIVES: After a large waterborne outbreak of Giardia infection in Bergen, some patients experienced persisting abdominal symptoms despite metronidazole treatment. This study aimed at investigating possible causes for their symptoms.

METHODS: Over a 15 month period, 124 referred patients were evaluated in a prospective cohort analysis with a standardised investigation including duodenal biopsies and aspirate, blood tests and faecal parasite and calprotectin tests. Recovered subjects were recruited for symptom analysis.

RESULTS: Persisting Giardia duodenalis infection was found in 40 patients (32.3%). Duodenal biopsies showed signs of inflammation in 57 patients (47.1%). Microscopic duodenal inflammation was present in 34 (87.2%) of the Giardia positive and 23 (28.0%) of the Giardia negative patients. There were significant associations between persistent Giardia positivity, microscopic duodenal inflammation and a positive calprotectin test. Duodenal aspirate and duodenal biopsies performed poorly in diagnosis of persistent giardiasis.

CONCLUSIONS: In patients with persisting symptoms after metronidazole treated Giardia infection we commonly found chronic Giardia infection and microscopic duodenal inflammation, especially in illness duration less than 7 months. Both these findings subsided over time. Increasingly, investigations could not determine a definite cause for the persistent symptoms. The very long-term post-giardiasis diarrhoea, bloating, nausea and abdominal pain documented here need further study.

 

[jaariel]

Sounds like they're totally convinced they're dealing with lazy slackers.

I wonder if they're so sure that they'd be willing to take blood transfused from a PWC.

It's Just like I've been telling my husband for years: we're branded "The Lazy Crazies" by the medical profession!

 

[jaariel]

Shakespeare

 

[jaariel]

what century are we living in? The middle ages? This a a travesty of unparallelled proportions!!!

i thought people might be interested in this piece by peter white (and a colleague, anthony clare - who is dead now) in a medical text book that is very widely used in the uk, and has been translated into other languages.

The index entry for me directs the reader to the entry for cfs. There is a very small entry in the infectious diseases seciton under the heading postviral/chronic fatigue syndrome, which states "studies have suggested that two-thirds of patients with a symptom duration of more than 6 months have an underlying psychiatric disorder".

as cfs wouid normally not be diagnosed within this timeframe, that means basically most of us have a psychiatric reason for our symptoms (according to them).


This section (and the index entry on cfs) then directs then reader to the cfs piece in section 22 (psychological medicine), where cfs/me is listed nder "functional or psychsomatic disorders: Medically unexplained symptoms".

anyway this is the text below and the details of the book.

kumar and clark - clinical medicine

by parveen kumar, cbe, bsc, md, frcp, frcp (edin), professor of
clinical medical education, barts and the london, queen mary's school
of medicine and dentistry, university of london, and honorary
consultant physician and gastroenterologist, barts and the london nhs
trust, london, uk; and michael clark, md, frcp, honorary senior
lecturer, barts and the london, queen mary's school of medicine and
denistry, university of london, uk

isbn 0702027634 paperback 1528 pages 1283 illustrations
saunders published august 2005


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

contributors include:

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

anthony w clare md frcpi frcp frcpsych mphil
professor of clinical psychiatry
trinity college, dublin;
medical director
st patrick's hospital, dublin, ireland

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

peter d white md frcp frcpsych
senior lecturer in psychological medicine, honorary consultant in
liaison psychiatry
barts and the london, queen mary's school of medicine and dentistry,
university of london, uk

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

<>

we all have illness behaviour when we choose what to do about a
symptom. Going to see a doctor is generally more likely with more
severe and more numerous symptoms and greater distress. It is also
more likely in introspective individuals who focus on their health.

Abnormal illness behaviour occurs when there is a discrepancy between
the objective somatic pathology present and the patient's response to
it, in spite of adequate medical investigation arid explanation.

Functional or psychosomatic disorders: Medically unexplained symptoms

`functional' disorders are illnesses in which there is no obvious
pathology or anatomical change in an organ (thus in contrast
to `organic and there is a presumed dysfunction in an organ or
system. The word psycho-somatic has had several meanings, including
psychogenic, `all in the mind'; imaginary and malingering. The modern
meaning is that psychosomatic disorders are syndromes of unknown
aetiology in which both physical and psychological factors are likely
to be causative, the psychiatric classification of these disorders
would be somatoform disorders, but they do not fit easily within
either medical or psychiatric classification systems, since they
occupy the hinterland between them. Medically unexplained symptoms
and syndromes are very common in both primary care and the general
hospital (over half the outpatients in gastroenterology and neurology
clinics have these syndromes). Because orthodox medicine has not been
particularly effective in treating or understanding these disorders,
many patients perceive their doctors as unsympathetic and seek out
complementary treatments of uncertain efficacy. Examples of
functional disorders are shown in table 22.4.

Because epidemiological studies suggest that having one of these
syndromes significantly increases the risk of having another, some
doctors believe that these syndromes represent different
manifestations in time of `one functional syndrome', which is
indicative of a somatization process. Functional disorders also have
a significant association with psychiatric disorders, especially
depressive and panic disorders as well as phobias. Against this view
is the evidence that the majority of primary care patients with most
of these disorders do not have either a psychiatric disorder or other
functional disorders.

Table 224

functional or psychosomatic syndromes (medically unexplained symptoms)

`tension' headaches
atypical facial pain
atypical chest pain
fibromyalgia (chronic
widespread pain)
other chronic pain syndromes
chronic or post-viral fatigue syndrome
multiple chemical sensitmty
premenstrual syndrome
irritable or functional bowel syndrome
irritable bladder syndrome

it also seems that it requires a major stress or a psychiatric
disorder in order for such sufferers to attend their doctor for help,
which might explain why doctors are so impressed with the
associations with stress and psychiatric disorders. Doctors have
historically tended to diagnose `stress' or `psychosomatic disorders'
in patients with symptoms that they cannot explain. History is full
of such disorders being reclassified as research clarifies the
pathology. A recent example is writer's cramp (p. 1233) which most
neurologists now agree is a dystonia rather than a neurosis.

Chronic fatigue syndrome (cfs)

there has probably been more controversy over the existence and
aetiology of cfs than any other functional syndrome in recent years.
This is reflected in its uncertain classification as neurasthenia in
the psychiatric classification and myalgic encephalomyelitis (me)
under neurological disorders. There is good evidence for this
syndrome, although the diagnosis is made clinically and by exclusion
of other fatiguing disorders. Its prevalence is 0.5% in the uk,
although abnormal fatigue as a symptom occurs in 10-20%. It occurs
most commonly in women between the ages of 20 and 50 years old, the
cardinal symptom is chronic fatigue made worse by minimal exertion.
The fatigue is usually both physical and mental, with associated poor
concentration, impaired registration of memory, irritability,
alteration in sleep pattern (either insomnia or hypersomnia), and
muscular pain. The name myalgic encephalomyelitis (me) is
decreasingly used within medicine because it implies a pathology for
which there is no evidence.

Aetiology


functional disorders often have aetiological factors in common with
each other (see table 22.5), as well as more specific aetiologies.
For instance, cfs can be triggered by certain infections, such as
infectious mononucleosis and viral hepatitis. About 10% of patients
with infectious mononucleosis have cfs 6 months after the infectious
onset, yet there is no evidence of persistent infection in these
patients. Those fatigue states which clearly do follow on a viral
infection can be classified as post-viral fatigue syndromes. Other
aetiological factors include physical inactivity arid sleep
difficulties. Immune and endocrine abnormalities noted in cfs may be
secondary to the inactivity or sleep disturbance commonly seen in
patients. Mood disorders are present in a large minority of patients,
and can cause problems in diagnosis because of the large overlap in
symptoms. These mood disorders may be secondary, independent (co-
morbid), or primary with a misdiagnosis of cfs. The role of stress is
uncertain, with some indication that the influence of stress is
mediated through consequent psychiatric disorders exacerbating
fatigue, rather than any direct effect.

Management

the general principles of the management of functional disorders are
given in box 22.7. Specific management of cfs should include a
mutually agreed and supervised programme of gradual increasing
activity however, few patients regard themselves as cured after
treatment. It is sometimes difficult to persuade a patient to accept
what are inappropriately perceived as psychological therapies' for
such a physically manifested condition. Antidepressants do not work
in the absence of a mood disorder or insomnia.

Prognosis

this is poor without treatment, with less than 10% ot hospital
attenders recovered after 1 year outcome is worse with increasing
age. Co-morbid mood disorder, and the conviction that the illness is
entirely physical.

Table 22.5 aetiological factors commonly seen in functional disorders

predisposing

perfectionist obsessional and introspective personality
childhood traumas (physical and sexual abuse)
similar illnesses in first-degree relatives

precipitating (triggering)

infections
chronic fatigue syndrome (cfs)
irritable bowel syndrome (ibs)
psychologically traumatic events (especially accidents)
physical injuries ('fibromyalgia and other chronic pain syndromes)
life events that precipitate changed behaviours (e.g. Going off sick)
incidents where the patient believes others are responsible

perpetuating ( maintaining)


inactivity with consequent physiological adaptation (cfs
and 'fibromyalgia').
Avoidant behaviours multiple chemical sensitivities (mcs) cfs
maladaptive illness beliefs (that maintain maladaptive behaviours)
(cfs)
excessive dietary restrictions (`food allergies')
stimulant drugs
sleep disturbance
mood disorders.
Somatization disorder
unresolved anger or guilt
unresolved compensation

box 22.7 management of functional disorders

the first principles is the identification and treatment of
maintaining factors (e.g. Dysfunctional beliefs and behaviours mood
and sleep disorders)

communication

explanation of ill-health, including diagnosis and causes
education about management (including self-help leaflets) .
Stopping drugs (e. G. Caffeine causing insomnia, analgesics causing
dependence)

rehabilitative therapies

cognitive behaviour therapy (to challenge unhelpful beliefs and
change coping strategies)
supervised and graded exercise therapy for approximately 3 months (to
reduce inactivity and improve fitness)

pharmacotherapies

specific antidepressants for mood disorders,analgesia and sleep
disturbance .
Symptomatic medicines (e.g. Appropriate analgesia, taken only when
necessary)

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

 

[Snow Leopard]

The above would be fine, if only it were actually true. I find it strange that they recommend such therapies, despite pointing out that "however, few patients regard themselves as cured after treatment".

Maybe that is because it doesn't work!?!

 

[cigana]

Hi Mark,

If you haven't already seen it, I think Prof Malcolm Hooper's talk on the physiological background of CFS and his views on the psychologist's lobby are really good for family and friends (if a bit long):

http://www.youtube.com/watch?v=7UpLuXFXJCc

Cheers,

Mark

 

[Dolphin]

PD White: Depression and chronic fatigue

PD White: Depression and chronic fatigue
(chapter in 2006 book) (Thanks to Doug Fraser)

http://books.google.com/books?id=V6...and chronic fatigue" "Peter D. White"&f=false

 

[Angela Kennedy]

Thanks for thread Dolphin and interesting discussion (will take more time to digest all) - but why oh why do the the Psycos still believe ME falls into their field. A quick response on Gabapentin - yes it does aid at a particular stage - I was on full dosage for at least 3 weeks. It allowed sleep and obviously affected/calmed in exactly the same way as full blown epilepsy (ie brain workings "haywire") Perhaps they should turn to Epilepsy Specialists for their answers.

The problem is, they're not! We are still stuck with psychiatrists dragging ME/CFS into their 'psychogenic' framework.

I have to ask you, Enid: do you understand that Dolphin and others are NOT supporting psychiatric explanations of ME/CFS, we are OPPOSING them?