Jeannette Burmeister has recently
presented grounds for considering the IOM definition to be inferior to the CCC.
In her blog, Jeannette says: "..
failing to exclude primary psychiatric disorders is absurd and even dangerous.."
And she says that depression in ME patients may be present but should be secondary to the ME: "
..depression is secondary, i.e., it followed the onset of, and was caused by, myalgic encephalomyelitis."
However, the CCC allows for
comorbid (not only secondary, as far as I can see) depression
and some other psychiatric disorders
and even somatization. And it even says that depression can
precede the development of ME/CFS by years:
"
Nonpsychotic depression (major depression and dysthymia), anxiety disorders and somatization disorders are not diagnostically exclusionary, but may cause significant symptom overlap."
"
Co-Morbid Entities: Fibromyalgia Syndrome (FMS), Myofascial Pain Syndrome (MPS), TemporomandibularJoint Syndrome (TMJ), Irritable Bowel Syndrome (IBS), Interstitial Cystitis, Irritable Bladder Syndrome, Raynaud’s Phenomenon, Prolapsed Mitral Valve, Depression, Migraine, Allergies, Multiple Chemical Sensitivities MCS), Hashimoto’s thyroiditis, Sicca Syndrome, etc. Such co-morbid entities may occur in the setting of ME/CFS. Others such as IBS may precede the development of ME/CFS by many years, but then become associated with it. The same holds true for migraines and depression. Their association is thus looser than between the symptoms within the syndrome. ME/CFS and FMS often closely connect and should be considered to be “overlap syndromes.”"
In her blog, Jeannette Burmeister goes onto say: "
The issue I am discussing here—psychiatric comorbidities—is so pivotal and potentially disastrous that I felt it necessary to flag it for the community right away."
However, she
is/was an advocate of the CCC: "
This effort is redundant because we already have a research definition that has been adopted by our experts, the Canadian Consensus Criteria."
Jeanette says that depression should be
secondary to ME, and should
follow the onset of ME, but the CCC says that depression can be comorbid and can
precede the onset of ME/CFS. (I'm not sure what the IOM have to say about depression, except that depression can be comorbid.)
So, I'm confused. This really doesn't explain to me why the new criteria are inferior to the CCC. But perhaps I've not understood something, seeing as it's all quite complex.
Unless I'm failing to understand something here, perhaps this is another example of blogging about the new criteria before taking time to consider the full implications of the new criteria, and considering the full context.
And, before I'm accused of anything, this isn't a "
personal attack" on Jeannette Burmeister. I greatly value her advocacy work, and I'm grateful for what she does. I'm simply critiquing the contents of a single blog, and expressing my confusion in relation to a complex issue.