Problems with the new IOM criteria

[adreno]

Years of resisting Wessely style interpretations have resulted in a false dichotomy: either patients have ME, or they are somatizers.

I think the reality is more complex and I'm not convinced that somatization even exists. If it does, it's probably very rare.

I agree, and if we dismiss the BPS school and psychosomatic medicine, then the argument that "somatizisers" can confound the SEID criteria is extremely poor. It seems unfathomable to me that anyone here would even use such an argument, stigmatizing as it is.

 

[Bob]

Re somatization, the CCC allows for comorbid somatization.
If I've understood correctly, the IOM criteria would allow for primary somatization.

(I would have thought that the difference between primary and comorbid somatization would be quite subtle, but I agree with others that a somatization diagnosis is probably questionable in any case.)

I think people are probably concerned that the new criteria will allow it be to claimed that ME patients have a primary somatization disorder, thus supporting the psych-lobby.

 

[adreno]

I think people are probably concerned that the new criteria will allow it be to claimed that ME patients have a primary somatization disorder, thus supporting the psych-lobby.

In the absence of objective biomarkers, I don't see how this is avoidable with any clinical diagnosis. It was still being claimed before SEID, and nothing has changed in that regard.

 

[Bob]

Responding to a comment made on another thread...

..they have stated that O.I is more prevalent than pain or myalgia on questionnaires and comments from patients.

I'm not sure if that's the case actually, Nielk. I've just been reading the pain section of the report and it says that pain research is inconsistent, and that one of the difficulties with pain studies is that they fail to distinguish ME patients from fibro patients, or comorbid ME/fibro patients. It also says that pain doesn't distinguish ME from other illnesses (i.e. pain is a common symptom in many illnesses). Furthermore, they say that up to 94% of Fukuda patients report experiencing pain (in which case 'pain' wouldn't distinguish CCC ME patients from Fukuda CFS patients.) I'm paraphrasing somewhat, so I recommend that people read it for themselves, in case I'm not accurately reporting what they say. Their very short summary/conclusion is on page 147. The pain section starts on page 141.

 

[Nielk]

Responding to a comment made on another thread...

I'm not sure if that's the case actually, Nielk. I've just been reading the pain section of the report and it says that pain research is inconsistent, and that one of the difficulties with pain studies is that they fail to distinguish ME patients from fibro patients, or comorbid ME/fibro patients. It also says that pain doesn't distinguish ME from other illnesses (i.e. pain is a common symptom in many illnesses) so it's not helpful to distinguish ME from other illnesses. Furthermore, they say that up to 94% of Fukuda patients report experiencing pain (in which case 'pain' wouldn't distinguish CCC ME patients from Fukuda CFS patients.) I'm paraphrasing somewhat, so I recommend that people read it for themselves, in case I'm not accurately reporting what they say. Their very short summary/conclusion is on page 147. The pain section starts on page 141.

If the concern is to distinguish SEID from Fibro, then fatigue should also not be included as a criteria, since fibromyalgia patients suffer from fatigue as well.

It is true that pain is common to many diseases but if that pain is more descriptive like headaches and myalgia, it might better define ME.
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