I don't usually bother with Sharpe on Twitter any more. I decided to have another go.
Trudie Chalders account of the history, does not even mention ME, even though 'In the summer of '89...' that is what it was called in the UK.he keeps insisting his research is on CFS and that it's different from ME
they need to make up their minds and stop constantly trying to rewrite history to justify their actions.
Yes, apparently it was these neurologists who got him into ME in the first place.It's interesting to note that the three authors of that paper quoted were at the National Hospital, Queen Square. Isn't that where SW was.
https://www.spectator.co.uk/2011/08/mind-the-gap-3/In 1987, I went to work as a trainee psychiatrist at the National Hospital for Neurology in Queen’s Square in London. One of my jobs was to see a group of patients who were not popular with the neurologists who ran the place. The patients had symptoms that might have had a neurological explanation — muscle pain, inability to walk, being unable to think clearly, feeling exhausted after the most minimal physical or mental exertion — yet the neurologists thought that they were at best suffering from depression or at worst swinging the lead. They found it irritating that the patients insisted they had an illness called ME (myalgic encephalomyelitis).
https://questioning-answers.blogspo...ial-for-chronic-fatigue-syndrome-a-reply.htmlI'm bringing the paper published by Michael Sharpe and colleagues [1] to your attention today in the interest of balance and peer-reviewed 'right to reply'.
The Sharpe paper concerns the PACE trial, the study which reported that "when added to specialist medical care, cognitive behaviour therapy and graded exercise therapy were more effective in improving both fatigue and physical function in participants with CFS [chronic fatigue syndrome], than both adaptive pacing therapy and specialised medical care alone."
Trudie Chalders account of the history, does not even mention ME, even though 'In the summer of '89...' that is what it was called in the UK.
'Chronic fatigue syndrome' was barely known and not officially used as a 'replacement' name until 1996 in the UK. The Fukuda diagnostic criteria were not published until 1994.
quite.I'd doubt that someone like Chalder could plausibly claim that she came into the field with "CFS" established to the point where she wouldn't even mention ME--that's ridiculous
So back to CFS then which is at the more severe end of that spectrum of fatigue, if you like, and back to the Maudsly and Kings.
I worked with Simon and Alicia Deal, and Isaac actually, he was involved in this, we conducted a randomised controlled trial where we compared CBT as we had piloted at the National Hospital for Neurology, and compared CBT with an active control which was relaxation.
So what changed in our study. Well the thing that changed and seemed to be associated with a better outcome was the belief that exercise should be avoided and that doing less helped fatigue. That was the thing that changed. What didn’t change was their belief in the fact that they had something physically wrong with them.
Here's their paper:quite.
Doing a bit more of the transcript and just popped back with this one:
we don't stand a chance as long as this stuff is being preached to medical students.
something for the NICE guidelines folk
@Keela Too @adambeyoncelowe @Jonathan Edwards
J Psychosom Res. 1998 Jul;45(1):77-83.
Illness beliefs and treatment outcome in chronic fatigue syndrome.
Deale A1, Chalder T, Wessely S.
Author information
Abstract
Longitudinal studies have shown that physical illness attributions are associated with poor prognosis in chronic fatigue syndrome (CFS). Speculation exists over whether such attributions influence treatment outcome. This study reports the effect of illness beliefs on outcome in a randomized controlled trial of cognitive-behavior therapy versus relaxation. Causal attributions and beliefs about exercise, activity, and rest were recorded before and after treatment in 60 CFS patients recruited to the trial. Physical illness attributions were widespread, did not change with treatment, and were not associated with poor outcome in either the cognitive-behavior therapy group or the control group. Beliefs about avoidance of exercise and activity changed in the cognitive behavior therapy group, but not in the control group. This change was associated with improved outcome. These findings suggest that physical illness attributions are less important in determining outcome (at least in treatment studies) than has been previously thought. In this study, good outcome is associated with change in avoidance behavior, and related beliefs, rather than causal attributions.
PMID:
9720857
[Indexed for MEDLINE]
whatever operational criteria we used for defining the syndrome the effects were the same. The treatments we found were safe given as described in the manuals and they are all downloadable from the website. And the bottom line really was that pushing the limits was better than staying within the limits as one would do with Adaptive Pacing therapy.
So you’d think that this would be good news.
[gasps from audience]
But these were some of the reactions of some of the M.E. groups.
“When is the Lancet going to retract this ?? study”
“There are deep problems with the credibility of the trial”
“We find the trial results extremely worrying”
And this is a classic
“That the trial shows that the therapies are safe and effective is hugely damaging”
So the Lancets response was “the evidence might suggest that it was the critics of the trial who might have formed their opinions first, ignoring the findings of rigorously conducted research”.
So why the anger, and the anger by the way continues to this very day with scores and scores of freedom of information requests and what have you.
Well I think it’s because a psychological treatment and even graded exercise therapy in terms of
a certain group of people, they feel that it implies that the condition is psychological, it might even imply that the person is lazy which clearly it doesn’t. And if people get better it means that the problem wasn’t real in the first place and it certainly wasn’t organic in nature.