Google translated from Czech to English. Some line breaks added. INTRODUCTION Patients with long-term physical problems that do not correspond to the findings of routine medical examinations constitute a significant portion of patients in general practitioners' offices and can be very burdensome for doctors and for the entire health and social system. According to current scientific knowledge and international recommended practices, it is necessary to identify these patients as soon as possible and approach them with special emphasis on building trust in the doctor-patient relationship and on the consistent application of the bio-psycho-social approach to their complaints. The authors of this recommended practice (DP) call this complex and fundamentally human approach to patients the "psychosomatic approach". It certainly represents the foundations of a medical approach to each patient not only in primary care, but for patients where routine diagnostic methods of medicine do not explain their problems and conventional therapy does not meet with the desired effect, a consistent psychosomatic approach is a necessity. And not only for the sake of patients, but also for doctors themselves, who, by adopting psychosomatic practice, can relieve themselves of frustration from the lack of results of their professional efforts and from unsatisfactory communication with dissatisfied patients. In 2015, the first DP of the Society of General Medicine focused on psychosomatic problems was created. This new DP is not a mere update of the older one. It defines its focus slightly differently and also offers a different perspective on the issue of functional and persistent physical problems in accordance with current global professional discussion and evidence-based good practice. In many ways, these two DPs complement each other and a general practitioner can certainly use both in his or her practice. However, according to the authors, this new DP should also be sufficient on its own to navigate the issue of functional disorders and the psychosomatic approach to physical problems. It is clear that not all recommendations will be feasible in all regions due to the lack of representation of psychosomatic and psychotherapeutic services. Optimal care can also be significantly limited by the financial availability of these professional services. The authors of the DP are convinced that not only the health, but also the social and economic impact of functional disorders and persistent physical symptoms is enormous (Rask et al., 2017) and requires an accelerated increase in the availability of psychosomatic health care covered by public health insurance. This change can only be achieved with constant pressure from the patient and professional public on politicians and health insurance companies, as well as on educational institutions. Open access
[Again, Google translated from Czech to English.] Functional somatic symptoms/disorders (FSS/FSD) are other terms used in the world to describe physical problems without clear organic findings (Burton et al., 2020). Usually, there is no distinction made as to whether the problems have a detectable biological correlate or not. The main point is that the main problem lies in a deviation or disorder of unconscious control and feedback processes. Since the terms PSS and FSD are relatively new and there is not yet much literature with this term, the authors of this DP use these terms interchangeably and refer primarily to sources discussing MUS. Functional disorders – defined specific syndromes: ... Chronic fatigue syndrome (CFS, sometimes referred to as myalgic encephalomyelitis) refers to a set of typical clinical symptoms dominated by severe, disabling fatigue that does not improve with rest. It is often accompanied by multifocal pain, sleep disorders, and cognitive dysfunction. The etiopathogenesis is not yet completely clear. Infection is considered as a trigger for CFS, as well as dysregulation of the immune system, mitochondrial abnormalities including impaired ATP production (Anderson, Maes, 2020), etc. The “diagnosis” is based primarily on history and physical examination. There are no selective diagnostic tests. There is currently no specific treatment for CFS, although comprehensive team care in centers focused on patients with CFS, based mainly on education, cognitive-behavioral therapy, and gradual increase in workload, leads to full recovery in some patients. It is generally recommended to educate patients in accordance with their readiness to receive explanations and recommendations and to provide them with supportive symptomatic care focused on the patient's needs that corresponds to this DP.
This is really appalling, especially if you remember how things went down for pwME in the Czech Republic a few years ago. The patient org wanted the country to adapt the new NICE guideline and the Ministry of Health kind of promised to develop one. Then unexpectedly the whole process was stopped because of the Czech medical association. (It seems the process of creating guidelines is very similar to how it works in Hungary, where the Ministy coordinated the work but the actual work was done by the Health Colleges.) This happened in 2022 in the Czech Republic, so it is a real slap in the face that they included ME/CFS in their psychosomatic guideline not much later.
for patients where routine diagnostic methods of medicine do not explain their problems and conventional therapy does not meet with the desired effect, a consistent psychosomatic approach is a necessity. 'If we cannot find a cause and do not have an effective treatment, it must be psychosomatic, and this interpretation must be forced upon the patient.' An utter perversion of reasoning, and an extraordinarily cruel betrayal. And it only gets worse from there.
They seem to be saying that the change they want can only be achieved with the help of patients (among other stakeholders) That means it won't happen, ever.
This has to be a joke. I keep reading and it's like every sentence just piles on more nonsense, like an actual parody. Even the weird "this isn't just an update", followed by "it's a slight variation". And presenting this "psychosomatic" concept as, somehow, new. Might as well have Astrology trucks on every street corner. Good grief these quacks are delusional. I have rarely witnessed less serious people do anything important. They simply put zero effort into it, and it shows. It's been used a lot in recent years, and boy does it fully apply here: the cruelty is the point. The cruelty is so clearly the point. The medical profession genuinely prefers to destroy millions of lives over admitting they got this completely wrong, they simply can't take responsibility for their actions, and have no scruples being mindlessly cruel and destructive if they can get away with it. And they sure can, they run the place, it's 100% their show, but they are never, ever responsible for anything.
The problem in Czech republic is that some prominent doctors with big influence are psychosomatic proponents of ME/CFS. They are very arogant and they block all ME/CFS discussions. They are not able to discuss professionally about ME/CFS. Big shame. But there are some small success, for example a small Covid/ Me/CFS centre in Hradec Kralove where few doctors got curious about these diseases and start to learn about these diseases.
