Evidence based care for people with chronic fatigue syndrome and myalgic encephalomyelitis, 2021, Sharpe, Chalder & White

rvallee

rvallee

Senior Member (Voting Rights)
https://kclpure.kcl.ac.uk/portal/en...is(536398c9-3ebe-4faf-b3bc-e01257e82c65).html


Abstract (Paragraphs mine for legibility)

Chronic fatigue syndrome (CFS), sometimes referred to as myalgic encephalomyelitis (ME) and often as CFS/ME, is an illness characterized by disabling fatigue and other symptoms, typically worsened by activity.

The main evidence-based treatments are rehabilitative in nature and include specific types of cognitive behavior therapy (CBT), and graded exercise therapy (GET). In this article we briefly review the evidence for their safety and effectiveness and propose that much of the controversy about them arises from misunderstandings about their nature and delivery. In particular, we emphasize that successful rehabilitation from CFS/ME does not indicate that the illness is not real.

We recommend that rehabilitative treatment always be preceded by a thorough clinical assessment and delivered by appropriately trained therapists working in close collaboration with the patient.

We conclude that properly applied rehabilitative treatments offer the best hope of safely improving fatigue and function for patients with CFS/ME. However, we also recognize the need for more research into the treatment of this neglected condition, especially for those most severely disabled by it.
 
Seems to have escaped notice, October 1. Not that there is much to notice, basically "we are right" and also No True CBT/GET, or something like that.

Also it appears that Sharpe and White have un-retired from... "chronic fatigue" I guess... research. Again. I'm sure we will be reading all over again about how they have to retire yet again.
 
It’s akin to a high school reunion where attendees flaunt their alleged achievements when in reality all they’ve accomplished is the dissemination of an appallingly inept trial.

Sharpe performs an impassioned, and hopelessly butchered version of Journey’s “Don’t Stop Believing” as the crowd awkwardly shuffles toward the exit.

With the punch bowl sponsored by the benevolent folks at Swiss Re!
 
rvallee said:
In particular, we emphasize that successful rehabilitation from CFS/ME does not indicate that the illness is not real.
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There is no convincing evidence of any successful rehabilitation. The reported effects are much smaller and don't exceed what would be expected from reporting bias alone.

In a sense the controvery is the result of misunderstanding, but by the CBT/GEt proponents who seem to confuse the bias they inject and fail to control for with successful treatment, and who seem to think that changing a patient's thinking for a short time equals a cure.
 
In particular, we emphasize that successful rehabilitation from CFS/ME does not indicate that the illness is not real.
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Translation: Mental illness is real too!

Well, good thing nobody is saying it isn't.

What is being said about your work and claims is that your definition of psychosomatic and how to diagnose and treat it is, um, problematic. At a very fundamental level.

But you don't want to answer awkward questions about that, do you? And never have.

Hence, the decades of sophistry and misdirection and victim-blaming.

(*I originally typoed 'threatments'. Over to you, Freud... :rolleyes: )
 
Sean said:
Translation: Mental illness is real too!

Well, good thing nobody is saying it isn't.
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(Not to be pedantic, but because I think it's important these things get dissected and understood well, so criticism isn't easily deflected.)

It's not exactly the translation of what they say, there's a step in between. It's a argument trick they've been using for a long time.

The translation is: the symptoms are real (and by symptoms they mean fatigue as the rest is usually dismissed as unimportant by-product), however, they stem from emotional disorder and deconditioning and are therefore easily reversed, the patient just believes it is from an actual disease, and it's not.

A bit like someone who has had a neck pain after a long and stressful meeting, who then would stop moving his neck and starts wearing neck braces because he thinks it is caused by a serious distinct issue that needs to be handled with unburdening. The pain is real, but there's no need for unburdening the neck or to use aids to help that. It would even be bad for your neck muscles and use. Get him to carefully use his neck again and he'll be fine.

It's a load of tosh and completely unfounded, but it makes ME fit the cognitive behaviour model (and lands far too easily because of deeply ingrained medical misogyny and ableism, especially in psychiatry), which then justifies them to apply their Product, CBT.
(Next to that, several of the ppl they have built their methods on also believed that biomedical illness always has a strong element of hysteria/hypochondria and never is actually as bad as a patient describes, so it always needs this sort of intervention. :devilish:)


So they treat it with a psychiatric treatment that is aimed at breaking through the "maintaining" factor of stopping activity when you get "symptoms". (It is e.g. not aimed at curing depression.)


They are psychiatric workers treating ME like a psychiatric illness much akin to hypochondriasis. However, by playing these sorts of semantic games (which for laypeople read like they do treat ME like a real illness and for ME patients (justly) sound completely incongruous as contrary to all the signs they are not treated like they have a real, biomedical illness), they deflect any criticism that they are not treating ME like a "real" illness, or that they think ME is psychiatric.

That baloney won't fly much longer of course, but they had a good run with it.
 
Arvo said:
It seems accepted but not yet in published? I can't find it on the publisher's search engine fo the journal, or Pubmed.

If anyone has access to the full paper, please send it to me, as I want to read it.
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Yes, accepted but not published yet. These university research portals often list accepted manuscripts before publication.

I'm sure we all can't wait until publication day.
 
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In some respects I’m looking forward to the full publication of this. I’m curious to see if they say anything new, which I doubt, and I’ll also look forward to the responses. As ever it’s nice to be reminded to donate.

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Arvo said:
(Not to be pedantic, but because I think it's important these things get dissected and understood well, so criticism isn't easily deflected.)

It's not exactly the translation of what they say, there's a step in between. It's a argument trick they've been using for a long time.

The translation is: the symptoms are real (and by symptoms they mean fatigue as the rest is usually dismissed as unimportant by-product), however, they stem from emotional disorder and deconditioning and are therefore easily reversed, the patient just believes it is from an actual disease, and it's not.
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Yes, that is more accurate. :thumbup:
 
NelliePledge said:
Attemp to rehabilitate reputations…….
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Early on Wessely was very focused on the idea of "saving face", when we go see a physician with psychological problems and are not given the opportunity to "fall into the sick role" it's necessary for the physician to help the patient "save face".

So much damn projection. But here they are trying to save face, because in the end all they care about is their reputation. There is something amazing with the fact that soon after being shown that their entire body of evidence is garbage, they still default to doing another carbon-copy paper of the same quality level, because it truly is the best they can do, along with citing evidence from 1912 and whatnot.
 
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