Editorial: Concern for Covid-19 cough, fever and impact on mental health. What about risk of Somatic Symptom Disorder? 2021, Willis & Chalder

John Mac

John Mac

Senior Member (Voting Rights)
People may also be at risk of persistent physical symptoms (PPS). Generally, these are defined as persistent bodily symptoms with functional disability but no explanatory structural pathology.

Somatic Symptom Disorder (SSD) is the corresponding diagnosis in the Diagnostic and Statistics Manual-V (DSM-V). It refers to persistent (6 months or more) and clinically significant somatic complaints accompanied by excessive and disproportionate health-related thoughts, feelings and behaviours regarding the symptoms (American Psychiatric Association, 2013).

Bodily Distress Disorder (BDD) is the diagnostic term used in the eleventh version of the International Classification of Diseases (ICD11). It requires both the presence of one or more distressing bodily symptoms, that can either be “medically unexplained” or caused by a general medical condition, with “excessive, disproportionate or maladaptive” responses to the symptoms.

Most importantly, both diagnostic terms include people with symptoms of distress related to medical conditions, for example, cancer, diabetes and heart disease. SSD describes a positive conceptualisation of symptoms based on presence of symptoms rather than absence of them. In addition, it moves beyond mind/body dualism, such that inexplicability does not equal psychiatric disorder, potentially leading to a better therapeutic alliance. Symptoms are not considered to be “in the mind” or solely due to distress (Chalder & Willis, 2018). For these reasons we prefer the diagnostic term SSD and will use it in the remainder of this article.
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https://www.tandfonline.com/doi/pdf/10.1080/09638237.2021.1875418
 
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It appears to be an effort on the part of MUS campaigners to colonize the category of all those suffering from non-specific symptoms for more than a certain period of time after a confirmed or suspected case of Covid-19. They are planting their flag on this territory building on questionable previous research.
 
dave30th said:
It appears to be an effort on the part of MUS campaigners to colonize the category of all those suffering from non-specific symptoms for more than a certain period of time after a confirmed or suspected case of Covid-19. They are planting their flag on this territory building on questionable previous research.
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Watch it fly

ETA I wonder if Dr Alwan (?) has seen this, or has any comprehension of what us potentially coming down the line in UK
 
NelliePledge said:
And there we go. Blatant. These people simply can’t help themselves in applying their b s thinking to anything that moves.

Needs bringing to the attention of the Long Covid community
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Does anyone please know how I can share this without giving them the ‘traffic’ of reads, or does this only apply when we are trying not to give newspaper articles the views? sorry, not ‘best brain’ available today.

Happy to share warnings of this to LC community on twitter, should I include any other evidence eg @Tom Kindlon studies??
 
It's even worse than I imagined. I have just waded through this drivel.

It repeats all the old stuff about 'psychological, social and behavioural factors' being implicated in causing and perpetuating 'somatic symptom disorder' in which they include CFS and long Covid. And recommends IAPT and concludes that more research of the same crappy sort they have been doing for 30 years should be done with people with long Covid.

:arghh:
 
The acute phases of covid-19 infection have involved stays in ICU with bed rest and for some this has been pro-longed. Previously, patients with acute lung injury have developed muscle weakness during ICU treatment associated with substantial impairments in physical function beyond24 months (Fan et al.,2014). Covid-19 patients may also beat risk from such long-term complications. Acute and post multi-disciplinary rehabilitation in hospitals and respiratory units may be effective for prevention of post-infectious fatigue and other symptoms (Ahmed et al.,2020). Educational interventions to limit bed rest and gradually increase activity have demonstrated effectiveness in reducing post-infectious fatigue associated with EBV (Candy et al.,2004). Similar interventions may therefore help medium to long term prevention of fatigue beyond the acute stages ofcovid-19 infection. Evidence-based treatments for fatigue and other persistent somatic symptoms are also well established and moderately effective. Cognitive behavioural therapy (CBT) demonstrates some of the strongest evidence for SSD (van Dessel et al.,2014). CBT is recommended as part of multidisciplinary treatment for high risk patients with SSD, whereas, low to moderate risk cases can be managed in primary care with a stepped-care disease management approach (van der Feltz-Cornelis et al.,2012). The SSD scale(SSD-12) demonstrates good psychometric properties and may assist clinicians with diagnosis and assessment(Toussaint et al.,2017). In the UK, persistent somatic symptoms are now managed in a stepped-care approach that includes the primary care based Improving Access to Psychological Therapies (IAPT) programme (McCrae et al.,2015), with step up referrals to secondary and tertiary care multi-disciplinary services (Chalder & Willis,2017).
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That Candy study doesn't demonstrate much. It was a small study and they tend not to mention that there was no significant difference in questionnaire scores at 12 months (the control group just got a leaflet telling then about EBV).

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More info here: https://www.s4me.info/threads/2003-...in-infectious-mononucleosis.8644/#post-152392
 
They can't even provide any evidence that this is of any use beyond the fact that people, mostly themselves, have been using it. It's the same recycled drivel they have been saying for 3 decades. Completely unchanged. I especially love that they quote this: “excessive, disproportionate or maladaptive”.

Who are they quoting? Themselves. And a judgment call that no human being has the ability to do. They are claiming mind-reading abilities.

As usual it's not that someone says anything this stupid, it's that it gets published and discussed, albeit superficially, by people who genuinely want to apply astrology-level nonsense in real life.

If there were justice in the world, these people would be sentenced to punishment based on a wheel spin. Just completely arbitrary and ideally built for maximum ironic cruelty.
 
Moved from the long Covid thread

Trial By Error: New Biopsychosocial Paper on Long-Covid and Somatic Symptom Disorder
Biopsychosocial Campaigners Target Long-Covid

New papers from the biopsychosocial campaigners often provide opportunities to highlight unwarranted assertions, misleading use of data, and—in particular–associations interpreted as if they were causal relationships and not, well, associations. An article co-authored by Trudie Chalder, a professor of cognitive behavioural therapy at King’s Collge London, and published recently in the Journal of Mental Health, deploys such strategies in its efforts to suggest that large swaths of those experiencing what is being called long-Covid are suffering from “somatic symptom disorder” (SSD).

The article, positioned as an editorial, is called “Concern for Covid-19 cough, fever and impact on mental health. What about risk of Somatic Symptom Disorder?” It recycles years of biopsychosocial shibboleths promulgated by Professor Chalder and her fellow campaigners.
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https://www.virology.ws/2021/02/09/...r-on-long-covid-and-somatic-symptom-disorder/
 
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From Mr Tuller's post:
The cited paper acknowledged this issue in the limitations section, noting that “the temporal ordering of the variables cannot be established, and so the potential problem of reverse causation cannot be ignored.” But that doesn’t stop the biopsychosocial campaigners from treating this “potential problem” of interpretation as an afterthought relegated to the “fine print” of limitations sections, not a serious hole in their argument.
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Exactly. It is their standard operating procedure: make a brief note of the limitation, then ignore it in their conclusions and recommendations.

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From the comment left by CT:

It seems that 38.2% of cardiology patients initially diagnosed with MUS were misdiagnosed, but this somehow doesn’t matter?!​

That is an awful lot of delay in diagnosis and treatment of a serious major killer. How that improves outcomes for it, or the rest of society, escapes me.
 
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Sean said:
That is an awful lot of delay in diagnosis and treatment of a serious major killer. How that improves outcomes for it, or the rest of society, escapes me.
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Delays in diagnosis for common neurological diseases are already several years on average. This will make it all so much worse. It's baffling that people whose job it is to think about that don't see it (or aren't concerned by it, hard to say which). Especially as they harp against biomedical research for being hard, the only thing that makes any significant progress in medicine. This here is pure regression.
 
I too love to just put labels and boxes in random orders to make what I guess must be some kind of point here.

Not sure how a CBT expert is also an expert in chronic illness but whatever it's not as if labels matter or something.

 
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