Study strongly calls into question the validity of broad based definitions of ME

[Daisymay]

This study shows that broad based definitions of ME/CFS, such as the Oxford criteria, clearly include significant numbers of patients with primarly mood disorder/psychiatric illness quite independently of a fatigue syndrome.

http://www.iacfsme.org/BULLETINSUMM...nalysisCohortTrial4481/tabid/435/Default.aspx


ABSTRACT

This paper presents a close analysis of a large published cohort trial into predictors (risk factors) for developing a fatigue syndrome or mood disorder following either infectious mononucleosis or an upper respiratory tract infection - White et al (16). Critically, in addition to utilising broad based definitions of ME/CFS, such as the Oxford and CDC CFS criteria, White et al also utilise a further definition, Empirical Fatigue Syndrome, which excludes current psychiatric illness. This provides important additional insights into the results, leading to conclusions which are materially different to those that the author draws, in relation to the inherent validity of broad based definitions of CFS and in relation to the significance of deconditioning as a perpetuating factor in this illness.

Examination of the data shows that the highest risk factor for developing a non-psychiatrically defined Fatigue Syndrome (i.e. Empirical Fatigue Syndrome), even 6 months later, is documented clinical evidence of viral infection (infectious mononucleosis) not previous psychiatric morbidity. Furthermore under the Empirical definition, no significant correlation exists between bed rest at onset and subsequent development of a fatigue syndrome; this suggests that deconditioning is not an important perpetuating factor under this definition.

Conversely, wider definitions of ME/CFS that do not exclude individuals with psychological/psychiatric reasons for their fatigue (such as the Oxford and CDC criteria) reduce the importance of clinical factors (infectious mononucleosis) and increase the importance of factors such as G.P. attendance in year before onset, mood disorder at 2 months and past psychiatric illness, which are consistent predictors of subsequent mood disorder quite independently of the existence or otherwise of a fatigue syndrome.

This analysis and the original data in the White et al. paper strongly calls into question the validity of broad based definitions of ME/CFS, such as the Oxford (and to lesser extent CDC) criteria. This is in large part due to the clear inclusion within such criteria of significant numbers of patients with primarily mood disorder/psychiatric illness in addition to those with ME/CFS.

Keywords: chronic fatigue syndrome, deconditioning, mood disorder, infectious mononucleosis

 

[hoverfly]

Thanks for this daisymay.

I'm struggling to keep up with all the latest news, but this seems an excellent, well written, criticism of the usual oxford/cdc claptrap.

Yet another nail in the Wessely school coffin.

It desearves a wider distribution.

 

[Marco]

Exerpt :

"In the above discussion we took Professor Whites analysis at face value. However, in arriving at the analysis he makes an adjustment to the data sets for Empirical and CDC defined Fatigue Syndromes at 6 months. Most pertinently of all the author states under statistical analysis that because there were only 16 cases of the empirical fatigue syndrome at 6 months, we added in the 26 cases of fatigue not otherwise specified to reduce type II error. Similarly, we added the 18 cases of idiopathic chronic fatigue to the 17 cases of CFS according to the definition of the Centres for Disease Control and Prevention (CDC) found at 6 months. These two categories defined participants with prolonged unexplained abnormal fatigue, but with insufficient accompanying symptoms or disability to qualify for the full syndrome.


Tut tut!!

 

[Dolphin]

If one looks at Peter White's talk at the viruses and ME/CFS seminar that was part of the HHV6 Foundation's conference in 2008 (still available I think), Peter White talks about the initial study a bit as evidence for his claim that "prevention is better than cure" i.e. get the people exercising early and you can prevent CFS. His paper doesn't show this at all when one puts it under the microscope the way David Sampson has. Peter White has influenced the CDC a lot in recent years - I think there is a good chance that was what they were thinking about when they were talking about prevention last year.

 

[Daisymay]

Quite agree Hoverfly

And it has been posted on to the main ME researchers and charities and onto many lists and forums too, so hopefully this will get noticed! It certainly deserved to be!

 

[Sean]

This is my favourite bit:

"Indeed it is clear from this study that wider definitions such as the Oxford criteria are in fact a "surrogate" term for mood disorder/psychological illness with fatigue as a symptom,..."

 

[OverTheHills]

Ooh I do love it when psychoidiots have their 'research' ripped to shreds so coolly. This chap Sampson goes on my Xmas list right next to Lenny Jason. As if I had any money.

OTH

 

[alex3619]

Hi, its an excellent analysis. I realized a long time ago that the data didn't match the conclusions for at least some of these studies, its nice to see this kind of rigorous analysis done. Now if we could get this done for all their research, the psychobabble research would be filed in the wastebasket. Bye, Alex

 

[free at last]

One wonders if the MRC will take note of this study, Especailly with whats happening with the retro virus evidence as of late, and the dundee study pointing to viral effects on white blood cells, All seems to be leading in the same direction doesnt it. At last some common sense. I and many others tried explaining all this to the likes of Wessley, but in our own very simplistic and desperately ill fashion. only to be distorted and twisted to suit there own pet theorys.

At last those twisted and distorted theorys are starting to crumble under the common sense of science and clarity. But those theorys have done so much damage already. That it will take a lot to undo the bias that it has gave those who struggled to belive a real illness was happening.

But i see a lot of that change just this week. this is a great week for suffereres a very poor week for white and wessley.

Heres something else for Simon and peter to ponder

Even if XMRV OR MLVs turn out to be non causative or non destructive ( as has been suggested here and there ) the fact that at least 80% of ME CFS patients seem to be carrying these retro viruses as oppossed to around 5% for healthy people, strongly suggests the immune system is some how weaker or damaged or fighting infection that is allowing the retro virus in our bodys, much much more than healthy people.

Either way this evidence is suggesting that our immune systems are being affected in some way, regardless if XMRV MLVs are causative or not. WE ARE MARKED and the proof is right there now for the world to see. This is not illness belief MR white, this is some sort of immune dysfunction and the high figures of retro viral infection. compared to healthy folk really are suggesting this strongly dont you think ? No doubt illness belief can make us all pick up retro viruses more cant they
IDIOTS really

 

[Dolphin]

Hi, its an excellent analysis. I realized a long time ago that the data didn't match the conclusions for at least some of these studies, its nice to see this kind of rigorous analysis done. Now if we could get this done for all their research, the psychobabble research would be filed in the wastebasket. Bye, Alex

Yes. Of course, one doesn't need to write a full article to challenge psychobabble research - letters to the editor can do it. But they usually have to be sent in fairly promptly (maybe within 6 months).

As well as challenging the individual piece, it can make "psychobabblists" or people who might be throw in a bit of psychobabble more cautious as they can become concerned dodgy stuff might be picked up on. It's a pity more people don't write letters to the editor: to write a full article is a lot of work but a letter doesn't have to be a huge amount of effort. Plenty of the people on the thread on the CDC study and personality thread could probably have written a letter but I get the impression none have gone in. (I'm busy writing an article at the moment and have draft of a letter that I may send in on another topic before people ask).

The problem is that if too much time passes, nobody can send in a letter to the editor and then maybe the only way a particular article can be challenged in print is an article like this which takes a lot of work. So people need to remember that it's best not to leave an article they are unhappy with lie too long. Be on the luck out for "bad" articles and challenge them early.

 

[Cloud]

Great find Dasiymay....thanks for sharing. Studies like this are gonna traumatize the poor little bedwetting pshychobabblers.

 

[pictureofhealth]

Great to see this kind of analytical study from someone who knows how to spot and extract the nitty gritty of an article and assess it with an academic eye.
I've not heard of D.P. Sampson before. He/She is an MBPsychS. Don't think this is a physician title as there would otherwise be an FRCP in there somewhere.
Perhaps - Member of the Board of Psychologists? Does anyone know what the S represents?
Anyway - would be good to see more of the same, especially as the IACFS/ME is foundation with an international basis/membership. Does this include physician membership does anyone know?

 

[Dolphin]

Great to see this kind of analytical study from someone who knows how to spot and extract the nitty gritty of an article and assess it with an academic eye.
I've not heard of D.P. Sampson before. He/She is an MBPsychS. Don't think this is a physician title as there would otherwise be an FRCP in there somewhere.
Perhaps - Member of the Board of Psychologists? Does anyone know what the S represents?

I think you're close. My educated guess for what it's worth based on his full list of titles (BSc (Hons), MSc, MBPsychS - first one is a Bachelors of Science and second is a Masters in Science) and this article is it stands for Member of the British Psychological Society. Possibly searching would find people with a similar title (or FBPsychS).

Anyway - would be good to see more of the same, especially as the IACFS/ME is foundation with an international basis/membership. Does this include physician membership does anyone know?

Yes, quite a lot of physicians are members - it was initially for professionals and researchers but they have let plebs in who'll pay the membership (I'm one).

 

[Dolphin]

I think you're close. My educated guess for what it's worth based on his full list of titles (BSc (Hons), MSc, MBPsychS - first one is a Bachelors of Science and second is a Masters in Science) and this article is it stands for Member of the British Psychological Society. Possibly searching would find people with a similar title (or FBPsychS).

Somebody on the MEA Facebook page corrected somebody who said they thought he was a psychiatrist, saying "he's a psychopharmacologist". That's not a term I've heard much so I'm guessing this person knows what they're talking about.