Open Emotion-focused digital interventions for patients with medically unexplained symptoms, Maroti et al

mango

mango

Senior Member (Voting Rights)
There was an ad in the newspaper DN.se today, inviting people to apply to participate in this study by Swedish BPS proponents Daniel Maroti et al (who are also running the MBS study). Not a recommendation, obvs.

Känslofokuserade digitala interventioner för patienter med medicinskt oförklarade symtom
https://www.su.se/forskning/forskningsprojekt/känslofokuserade-digitala-interventioner-för-patienter-med-medicinskt-oförklarade-symtom
Auto-translate said:
Emotion-focused digital interventions for patients with medically unexplained symptoms

Stockholm University - Research project - Research projects

Functional somatic syndromes (e.g. irritable bowel syndrome, fibromyalgia) and medically unexplained symptoms (e.g. chronic primary pain) are very common in primary care. These patients make 14 times more doctor visits than the general population, but describe themselves as less satisfied with the care they receive.

Previous research shows that relatively few patients feel they are helped by the treatment they are offered.

Short-term psychodynamic therapies such as Emotional Awareness and Expression Therapy (EAET; Schubiner & Lumley, 2019) and Intensive Short Term Psychodynamic Therapy (ISTDP) have recently been evaluated in three systematic reviews (Abbass et al., 2020, 2021, 2022) and show good results for patients with medically unexplained symptoms.

Short-term psychodynamic therapy considers that good treatment outcomes for patients with functional somatic syndromes can be achieved by increasing awareness of emotions and teaching patients to better experience, express and regulate emotions.

Purpose of the research project

The purpose of this project is to use a recently developed form of therapy, psychodynamic short-term therapy (EAET and ISTDP) to clarify the effects of the treatment but also to contribute to information on how care flows for the patient group can be created. The project also aims to study whether patients' own disease descriptions and ability to process emotions affect how they utilise treatment.

Register as a research participant

On 1 December 2023, the project plans to start recruiting about 180 research participants with functional symptoms or medically unexplained symptoms who will be offered to participate in emotion-focused digital interventions (EAET/ISTDP).

Do you want to be part of a scientific study on the treatment of long-term physical symptoms?
Click to expand...

Vill du vara med i en vetenskaplig studie kring behandling av långvariga kroppsliga symtom?
https://www.su.se/forskning/forskningsprojekt/känslofokuserade-digitala-interventioner-för-patienter-med-medicinskt-oförklarade-symtom/vill-du-vara-med-i-en-vetenskaplig-studie-kring-behandling-av-långvariga-kroppsliga-symtom-1.657965
Auto-translate said:
[...] What is MBS?

Throughout the project, the abbreviation "MBS" (mind-body syndrome) is used to refer to a larger group of physical disorders, such as migraine, IBS (irritable bowel syndrome), fibromyalgia, chronic fatigue syndrome, back pain, whiplash and others. We use the term because body and mind are closely linked in many cases of physical disorders.

Current neurological research shows that bodily symptoms can occur even in the absence of physical pathology in the body. According to this research, symptoms arise as a result of sensitised neural pathways in the brain.

Research has shown that these neural pathways that cause symptoms can be relearned. Re-training these neural pathways is exactly what this project is about.
Click to expand...
 
That they still include migraines in this just shows how intellectually bankrupt this whole ideology is. If it wasn't for Marshall and his team, peptic ulcers would still be THE main, uh, I guess it's "mind-body syndrome" now, and we all know that. But even though migraines have had significant breakthroughs over pathophysiology and treatment, there is a huge delay in how knowledge gets translated into medical practice and research, so somehow they are still there. Along with back pain? And whiplash? Good grief.

Medicine is the only expert profession to have ever regressed over time. And this isn't growing pains, medicine is the oldest expert profession in the world, it has existed for thousands of years. There are entire expert disciplines that are newer than the entire CBT/GET paradigms and never even came close to this level of ineptitude. Because results actually matter in those.

This is really the medical equivalent of "tough on crime". It's well-documented that this approach doesn't work, is far more expensive and even leads to worse outcomes. But even though it's generically asinine, it sounds good when you want to get elected to office. You have to be tough on criminals, how could you not? Just the same, medicine has to be evidence-based, how coud it not? And people who are ill have to be rehabilitated, how could they not? Results don't matter, methods don't matter, it's just a giant circle jerk based entirely on the hubris that they could not possibly not understand everything yet, and therefore anything they don't understand is this magical nonsense where results conveniently never matter.

And of course the people most likely to participate in such a trial are more likely to want to please and answer positively, even if they end up worse. And so the failure loops on forever, the money trolley just keeps chugging along the tracks. Incredible.
 
There's a pretty insulting comment by one of the psychologists responsible for the study, under Maroti's public Facebook post about the study. Is he not aware of the "a day with the muppets" debacle, or does he simply not give a eff?
Peter Lillengren said:
Participants need to read and speak Swedish fluently, so limited to Swedes and muppet chefs!
Click to expand...

Very good to see, though, that Nina E Steinkopf and others have questioned the inclusion of pwME. Maroti apparently hasn't even bothered to reply :grumpy:
 
Another article published in September 2023:

Funktionella somatiska symtom och nya behandlingsperspektiv: Psykodynamisk känslofokuserad korttidsterapi har god effekt
https://lakartidningen.se/klinik-oc...matiska-symtom-och-nya-behandlingsperspektiv/
Läkartidningen said:
Functional somatic symptoms – short-term psychodynamic therapy can be helpful

Patients with functional somatic symptoms or medically unexplained symptoms are very common in the healthcare system but they do not always receive adequate care or treatment. These patients struggle with a low quality of life and constitute a high cost to the healthcare system. Cognitive Behavioral Therapy is a relatively common treatment intervention and helps many patients, but not all. Short-term psychodynamic therapy has recently been evaluated in several meta-analysis and have been found to be clearly effective. A major focus of short-term psychodynamic therapy is on emotional processing of stressful or traumatic life events. At present, these psychodynamic short-term therapies are not offered in regular care, despite the solid research support that exists. Short-term psychodynamic therapy should be considered a complement to the range of treatments that already exist for patients with functional somatic symptoms.
Click to expand...
 
Arnie Pye said:
How can either of those be classified as MUS? Iron deficiency is the most common nutrient deficiency in the world, and how can someone not say to their doctor "Oh, I hurt my knee last month and it isn't getting better, can you take a look at it?"
Click to expand...
He says they happened at a time in his life with lots of psychological stress, but doesn't go much into detail beyond that.
 
mango said:
There's a pretty insulting comment by one of the psychologists responsible for the study, under Maroti's public Facebook post about the study. Is he not aware of the "a day with the muppets" debacle, or does he simply not give a eff?


Very good to see, though, that Nina E Steinkopf and others have questioned the inclusion of pwME. Maroti apparently hasn't even bothered to reply :grumpy:
Click to expand...
I read that as him trying to be funny, there was a smiling emoji att the end of the sentence. Not the best time and place for jokes though, I agree!

I don't know what the "a day with the muppets" debacle is? Should I know that?
 
Last edited:
Anna H said:
I don't know what the "a day with the muppets" debacle is? Should I know that?
Click to expand...

Trish said:
One of the many names given to patients with symptoms that doctors have trouble diagnosing is Medically unexplained symptoms (MUS), also called Medically unexplained physical symptoms (MUPS), or Medically unexplained physical and psychological symptoms (MUPPS). A group of doctors were running a day conference on MUPPS and had the crazy idea of calling it 'A day with the Muppets'. They probably thought this was hilarious. Patients heard about it and objected, but too late to change their publicity. As has been explained, in the UK calling someone a muppet is an insult.
Click to expand...

Trish said:
The problem with the MUPPETS title of the conference was not the intent but the crass insensitivity of the idiots who thought it was funny and chose to use it as the title. When confronted they claimed they were calling themselves muppets, but that's not how it came across. They did change it on the day, but the damage was done.

The point David was making, I think validly, was that Esther Crawley agreed to give the keynote address at a conference titled 'A day with the Muppets' (if I remember it correctly). A sensitive paediatrician would have objected and insisted they change it before she agreed to be their keynote speaker. And incidentally, some of us followed the talks on twitter until her talk was due to start, when there was complete twitter silence, presumably at her insistence
Click to expand...

David Tuller said:
On May 18th, Professor Crawley gave a talk at a conference in Devon whose title jokingly referred to children suffering from “medically unexplained physical, psychological symptoms” as muppets. In the U.K., that word is considered a slur that means, according to the BBC, someone who’s stupid, gullible and incapable of independent thought. (In the U.S., the term generally refers only to Miss Piggy and her various puppet-friends; it is not considered an insult, as far as I know.)

http://virology.ws/2017/12/04/trial-by-error-my-one-sided-correspondence-with-professor-crawley/
Click to expand...

ME Association said:
A barrage of complaints about the title broke out yesterday as soon as details of the study day were circulated on the internet and social media.

Typical of the complaints was this one from MEA medical adviser Dr Charles Shepherd, who came late to the controversy yesterday evening. He emailed South West Paediatric Club, who organised the study day, first thing this morning. Dr Shepherd wrote:

Having seen the details of your study day – with the title A Day with the MUPP(ET)S – on the internet, a number of our members are contacting The ME Association to say that they find the title, which I assume was used to create interest and amusement, to be unprofessional and insulting to children with unexplained medical symptoms, as well as to children and adolescents with ME/CFS, which is one of the subjects being covered.

As I am sure you are aware, the dictionary definition of a MUPPET is quite derogatory: An alternative term for an idiot or moron. Usually used in the UK to describe someone who is incompetent or gormless. So I have to agree that this is a highly inappropriate and disrespectful title to use for a study day covering what is a very sensitive medical subject.

Using the term MUPPET clearly implies to the patient community that these sort of symptoms are being trivialised and even laughed at by the medical profession.

https://meassociation.org.uk/2017/0...with-title-for-todays-conference-18-may-2017/
Click to expand...
ETA: Re: "Usually used in the UK to describe someone who is incompetent or gormless." I forgot to add that this is also exactly how the term "muppets" ("muppar" in Swedish) is used where I live, in Sweden.

ETA:
Anna H said:
I read that as him trying to be funny, there was a smiling emoji att the end of the sentence. Not the best time and place for jokes though, I agree!
Click to expand...
Sorry about the emoji getting lost when I copied it from the Facebook app. I didn't notice.
 
Last edited:
Arnie Pye said:
I can't see the connection between iron deficiency or a knee injury and psychological stress. The man who said that appears to be just waffling.
Click to expand...
I agree with you completely. It doesn't make any sense at all.
Psykologtidningen auto-translate said:
I myself have had medically unexplained symptoms, including medically unexplained iron deficiency. Iron deficiency is very uncommon among men. I also have a knee injury, parts of the cartilage are missing in my left knee. You can get such an injury after a car accident, but I haven't been in a car accident.

When Daniel Maroti has not received answers from medicine, he has looked for explanations in psychology.

- 'I think my problems have been related to psychological stress. Whether this is really the case I don't know, of course. But why do I get iron deficiency during a period in my life when I am going through a major change that eventually leads to a separation? The obvious answer is that my body was leached.
Click to expand...
Psykologtidningen originial quote said:
Jag har själv haft medicinskt oförklarliga symtom, däribland medicinskt oförklarad järnbrist. Bland män är det ju jätteovanligt med järnbrist. Jag har dessutom en knäskada, delar av brosket saknast i mitt vänstra knä. Efter en bilolycka kan man få en sådan skada, men jag har ju inte varit med om någon bilolycka.

När Daniel Maroti inte har fått svar från läkekonsten har han sökt förklaringar inom psykologin.

– Jag tänker att mina problem haft med psykologisk belastning att göra. Om det verkligen är så vet jag förstås inte. Men varför får jag järnbrist under en period i livet när jag genomgår en stor förändring som så småningom leder till en separation? Det ligger nära till hands att tro att kroppen var urlakad.
Click to expand...
 
Arnie Pye said:
I can't see the connection between iron deficiency or a knee injury and psychological stress. The man who said that appears to be just waffling.
Click to expand...
It doesn't say in the interview if Maroti has treated and tried to recover from his MUS (ie restore his iron levels and the missing cartilage in his knee) through EAET or CBT, and if so whether the treatment was successful or not :whistle:
 
Last edited:
mango said:
It doesn't say in the interview if Maroti has treated and tried to recover from his MUS (ie restore his iron levels and the missing cartilage from his knee) through EAET or CBT, and if so whether the treatment was successful or not :whistle:
Click to expand...

I'm sure people would love to know how to create iron and cartilage with the power of thought. The world wouldn't need miners for digging up iron ore - they could just teach everyone how to create something out of nothing.
 
It probably goes without saying that neither of those things are symptoms, let alone medically unexplained ones. Perhaps he had symptoms of tiredness, weakness and knee pain. Good news, those symptoms are now medically explained by the results of these investigations (iron levels and knee MRI). If you start calling every disease we don't fully understand "medically unexplained symptoms" you're going to have to include nearly everything, especially cancer and most neurodegenerative diseases.

Which brings us back to one of Jo's elegant comments from a few years ago —

Jonathan Edwards said:
Ordinary headache is medically unexplained, despite various unconvincing explanations being popular (tension etc).

Everybody gets ordinary headaches.

So the prevalence of medically unexplained symptoms is 100%.
This is, if we are defining MUS simply as medically unexplained symptoms.

But clearly that is not what is meant by MUS for those who make a living out of it. They mean symptoms that are unexplained but are due to somatisation. This is clearly a contradiction because they are now explained.

So the prevalence of MUS is 0%.
Click to expand...

The corollary is that it's not a contradiction.

1. Symptoms are medically unexplained.
2. Symptoms are explained by somatisation.
3. The concept of somatisation is not part of medicine. QED.
 
mango said:
ETA: Re: "Usually used in the UK to describe someone who is incompetent or gormless." I forgot to add that this is also exactly how the term "muppets" ("muppar" in Swedish) is used where I live, in Sweden.

ETA:

Sorry about the emoji getting lost when I copied it from the Facebook app. I didn't notice.
Click to expand...
OMG!! Thanks for taking the time to explain.
Now I understand:(. (I'm a fan of "The Muppet Show", but I see now how insulting such a comment is coming from him especially)
 
You must log in or register to reply here.
Back
Top Bottom