boy diagnosed with autism when he just needed antibiotics

Unable

Unable

Senior Member (Voting Rights)
Mental health issues? Autism? Or really an infection causing changes to the brain?

Interesting article from BBC.
https://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-46989099

“A mother is calling for greater awareness of a little-known condition she believes changed her easy-going son overnight.

Alison Maclaine fears some children are being misdiagnosed with autism and mental health issues when they are really suffering an infection which can be treated simply with antibiotics.

Her eight-year-old son Jack suffered distressing personality changes and "lost a year of his life".”



I have long wondered whether many apparently “mental health” conditions, where the patient is sent to psychiatric services for CBT (or is that re-programming?), are actually of an organic nature? This would seem to be another example of an area where psych type services fail patients.
 
PANDAS were first recognised in the US in 1998. So not that long ago.

What I don't understand is why the initial strep infection was not noticed (antibiotics would have been the only appropriate treatment). How do you have such an infection without any signs of it? Or was it treated and then this still happened. It's not clear to me.
 
Much of what we think of as infections is actually the immune system reacting to the invader, think runny nose, fever. It follows that an infection we don't notice so much could be causing more damage than one which lays us up in bed.
 
A year into my daughter's ME her ASO titre (Anti streptolysin O) was tested. It was found to be double the upper limit of the normal range. She was put on 6 weeks of I/M penicllin and improved hugely after about 4 weeks for a few months. She had the cognitive function and stamina to study , sit and pass 2 AS levels in these 4 months.

There was no evidence of strep infection such as fever, sore throat, skin probs. She developed tonsillitis about 2 1/2 months in ? rebound. She had never had tonsillitis previously. This was treated with a standard course of Azithromycin (5 days from memory), followed by one tablet Mon, Wed, Fri for 4 weeks afterwards.
The docs thought that she maybe had a lurking deep infection in her tonsils and these were then removed.

Sadly the improvement did not last.
 
Sorry to hear the improvement was short lived, but very interested to hear the other stuff.

I have to admit ME to me feels like an infection of some sort that is lingering. Best month I’ve had since getting ME was the one after a week on antibiotics for an unrelated injury.
 
I'm eager to be proven wrong, but my confidence has only grown over time that I'd estimate that likely 90%+ of all mental illness has a biological explanation, most likely the immune system or foreign particles/chemicals interfering with biological processes, and that most of them are treatable. This whole psychologisation of medicine experiment is one of the biggest mistakes in the history of the profession (not something that I say lightly seeing how massive those failures have been) and will be recognized as such over time, once we've rooted out the psychologist of the gaps.

Suspend all this stupid "thoughts and feelings" stuff, do a massive push in real science-based biomedical research and we'll eradicate most of those illnesses. There will be some left, a few people where it's a combination of both, but the vast majority exist entirely within the gaps in our understanding of biology. Ultimately it's largely a self-fulfilling prophecy because of the stubborn refusal to do research in case it may fail, which is the entire point of doing research so I don't know where this idea comes from. No surprise that the remaining controversial diagnoses all share this distinction of having been under-researched.

All this does is hurt everyone. Sick people take over resources that cannot help them and only become sicker over time. People who need psychological support are having their access restricted and so it's hurting them as well. Psychotherapists are frustrated because they see more and more patients they cannot possibly help. Physicians are frustrated because they send their sick patients down a black hole from which they never return and cannot possibly help them, they get yelled at justifiably but over things they have no control over.

This is a supremely dumb, idiotic experiment. Magical thinking doesn't work any better when it's done by licensed professionals. Plenty of licensed physicians have and still do sell snake oil. Complementary and alternative medicine is not defined by who practices it, but rather by what evidence base it has. This whole psychosocial thing is complementary and alternative medicine being given fake credibility by playing performative superficial hand-waving using dodgy maths and the appearance of serious methodology.
 
And of course the remaining patients with “psychiatric problems” could likely be helped if there was a genuine benefits system for those out of work, and fair living wage for those in work. But it’s much easier to just apportion blame. :(
 
Mithriel said:
Much of what we think of as infections is actually the immune system reacting to the invader, think runny nose, fever. It follows that an infection we don't notice so much could be causing more damage than one which lays us up in bed.
Click to expand...

I guess that's possible. But these PANDAS I think if I understand correctly relate to strep. And I think it would be difficult (and not wise) to ignore a strep infection.
 
Unable said:
I have long wondered whether many apparently “mental health” conditions, where the patient is sent to psychiatric services for CBT (or is that re-programming?), are actually of an organic nature? This would seem to be another example of an area where psych type services fail patients.
Click to expand...

I would not be too quick to come to a conclusion.

This was clearly a psychiatric problem. We do not know the cause of most psychiatric problems and they are all 'biological' so calling it PANDAS does not change the category.

I am not sure what the term PANDAS adds. It really means 'we think this might be the after effect of a streptococcal infection although we cannot be sure and even if it is we have no idea why'. The doctor's site (Dr Ubhi) refers to people theorising about PANDAS being due to molecular mimicry, which is likely to be nonsense.

Sure, there is a lot we don't know about psychiatric problems, but they are still psychiatric problems and it is best to admit we don't know.
 
rvallee said:
I'm eager to be proven wrong, but my confidence has only grown over time that I'd estimate that likely 90%+ of all mental illness has a biological explanation
Click to expand...

I have always assumed that. I am not sure anyone was suggesting in this case that psychologising about thoughts and feelings and childhood trauma etc. was relevant. The issue is simply which diagnostic category is most useful.
 
I think @Jonathan Edwards your clinical understanding of “psychiatric” (presumably as something that is affecting behaviours, and mood etc. as opposed to affecting a physical function) is different from the lay interpretation of “psychiatric” (that the person failing in some way - ie is weak willed, just needs to pull self together etc).

The BPS group are good at merging these two things, whilst actually blaming the patient. Sure some CBT might reframe the approach to the mood problems (even if organically generated) but I don’t see them as a means to recovery. If there are people who recover from deep seated psychiatric problems with treatments such as antibiotics then conventional psychiatric treatments such a s CBT are not the answer.

I hope I’m sorta making sense.

You might be using the word psychiatric to describe the nature of the symptoms, whereas the lay person uses it to describe what they see as the root cause (ie a personality failing).
 
Unable said:
You might be using the word psychiatric to describe the nature of the symptoms, whereas the lay person uses it to describe what they see as the root cause (ie a personality failing).
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I hope that very few, even lay people, use the term in that sense because that is not what it means. Most people accept that psychiatric conditions like schizophrenia or autism are not due to personality failings (whatever that might mean).

The problem is that journalists flag up this sort of story to stir up emotions without much clue what they are actually saying. All the story says is that the mother thinks the psychiatric diagnosis was the wrong one (autism instead of PANDAS).

The BPS people are quite specifically talking about something other than psychiatric. They are talking about 'psychological' causation - whatever that is supposed to mean. In this sense 'psychological' is something quite different from 'psychiatric'. It may well mean feeble willed in the sense you suggest but the BPS people, as you say, never quite commit themselves on that. They just assume it and pretend that is not quite what they assume.

I guess basically I am saying that this unfortunate case has nothing to do with the problems of the categorisation of ME.
 
The underlying problem here is that bacteria and viruses can cause symptoms that are being confused with psychiatric conditions. It is particularly problematic when it can be cured by a course of antibiotics. Stomach ulcers are a case in point.

At one point, medicine believed every unknown illness was caused by an infection (I have a 1930s medical book where this is the case), now it is psychological unless proven otherwise.

This is not a good atmosphere to pick up unusual consequences of common infections.
 
Mithriel said:
The underlying problem here is that bacteria and viruses can cause symptoms that are being confused with psychiatric conditions. It is particularly problematic when it can be cured by a course of antibiotics. Stomach ulcers are a case in point.
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My point was that I think this is the wrong analysis. Psychiatric means disturbed thinking. That would include problems due to hypothyroidism, infection, or whatever. All doctors are taught that infections can cause psychiatric problems.

Moreover, the evidence for any one person having PANDAS is pretty speculative. The chances that antibiotics will help are probably close to zero because the bacteria will have gone long before the diagnosis is made. PANDAS is based on a theory extrapolated from rheumatic fever that is probably wrong.

Whether or not other conditions due to infections were misunderstood is irrelevant. We need to treat each case on its merits. BPS theory may well be rubbish but it does not help to replace one lot of rubbish with other rubbish just because it sounds less stigmatising.
 
Re the prevailing concept that diseases such as schizophrenia are not due to character flaws; what can be said for psychiatrists who do not authorize full disability benefits for patients with schizophrenia because doing so would erode the patient's motivation to get well?

I have this on good authority from a professional with decades of experience working in the disability field with these patients. (Outside the UK.)
 
DokaGirl said:
Re the prevailing concept that diseases such as schizophrenia are not due to character flaws; what can be said for psychiatrists who do not authorize full disability benefits for patients with schizophrenia because doing so would erode the patient's motivation to get well?
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I have never heard of anything like that and it seems most improbable. I have never heard of a psychiatrist suggesting that getting better from schizophrenia has anything to do with motivation to get well. You say it is outside the UK - I cannot think where it would be.
 
This was a well known, common practice that social advocates worked to remedy; psychiatrists denying full disability status for those with mental illness. Many were put on temporary disability status, which was less money. This temporary status meant periodic reviews with the concern that one would be cut off. Less funds of course effected housing, and all other living costs.

Eventually, this problem boiled over following a new government policy that said those on temporary disability status would be reduced to receiving even less funds. Advocacy groups were able to help a great many people in this predicament.

As regards where this practice was popular - Canada.
 
DokaGirl said:
This was a well known, common practice that social advocates worked to remedy; psychiatrists denying full disability status for those with mental illness.
Click to expand...

Mental illness is not the same as schizophrenia. And 'social advocates' can pick up all sorts of wrong ends of sticks. I honestly think this has nothing to do with the case being discussed which is purely about the name given to a child with a psychiatric disorder and whether it is more or less useful because it refers to a particular bacterium.
 
@Jonathan Edwards

This practice included those with schizophrenia. And, people with mental illness diagnoses.

Social advocates did remedy this situation, however, my information source is a professional who did not work in the social advocacy field, but rather in an official capacity. This was a significant problem that came to be known by many before it was fixed.

Re the relevency of this input: I was following up on your and @Unable's discussion about mental health issues and character flaws. Reducing disability benefits to motivate those with schizophrenia, and mental illness could be seen as a remedy for treating those patients suspected of malingering. The belief being that reducing the flow of money would get these patients motivated to get well, and go back to work.

As for the initial story itself, I wonder why this potential cause of mental health problems is better known in the US, than the UK. It is unfortunate, to say the least, that a child and his family had to suffer for several months before the correct diagnosis, in this case a biomedical one, was found.
 
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