Guidance for commissioners of services for people with medically unexplained symptoms - 2017

Membership of the committee producing this included: Mind and Rethink Mental Illness.

They seem like pretty docile Establishment bodies to me. Maybe it would be worth trying to engage them in discussion about their representation of patients concerns. I wonder what expertise they claim to have with MUS?
 
Thanks for posting this @Sly Saint. I've read it. It's dire.

Basically it's the BPS crew trying to take over all the symptoms and syndromes they call MUS and have clinical commissioning groups in the UK commission 'services' that are generic teams of therapists of every description doing directive CBT on us all. If we get rid of ME/CFS services, this is what is planned to replace it. I gather it's already happening. They use PACE as part of the justification for it.
 
Arnie Pye said:
All this document says to me is that doctors are no longer taught how to diagnose anything and they aren't worth the air they use.
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I agree. It is complete and utter b****cks.
They say 45% of patients in rheumatology outpatients have MUS. 95% of the people I used to see had reasons for their symptoms that were not too hard to track down.

It seems they are trying to persuade commissioners to set up brand new MUS services. I just wonder how many people are going to be prepared to be given an appointment for the 'you are nuts and there is nothing wrong with you clinic'. I think this might just fall flat on its face.

Surprise surprise they think we need a multidisciplinary team.
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Patients with MUS are more likely to attribute their illness to physical causes, rather than lifestyle factors. This can include symptoms such as pain in different parts of the body, functional disturbance of organ systems and complaints of fatigue or exhaustion.
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I am always surprised by the passive aggressive psychotic comments like this, that always seem to appear with anything related to MUS / SOLK / BDS

The risks or associated factors for MUS include being female, younger in age, and currently employed. Childhood adversity and/or abuse, and the severe illness or death of a close relative are also factors associated with MUS. MUS may be caused by physiological disturbance, emotional problems or pathological conditions which have not yet been diagnosed.
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Haha, those crazy little girls, with their periods, boyfriends, ovaries and emotions no wonder they are sick all the time.

Psychiatric morbidity is not directly associated with the presence of MUS, but is more likely in those complaining of multiple symptoms. In severe cases of MUS, there is overlap with personality disorder.
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Ah yes, the sicker you are, the crazier you are likely to be


I don't get how its 2018 and people still believe in this nonsense.

The literature they cite as ''explanation'' for MUS is even worse - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083258/

Thank god they don't expand on that in this guidance

If you live in the UK you have to fight this idiocy as much as you can. Once this sort of stuff sticks, like in Denmark or The Netherlands, it is incredibly hard to get rid off.
 
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Patients with MUS are more likely to attribute their illness to physical causes, rather than lifestyle factors.

More than who? More than people with broken legs or psoriasis? And in what sense are lifestyle factors not physical causes? Are going to bed late, drinking too much, sleeping around, eating bacon, or lying on a sofa purely mental events?

You can't make it up can you.

I think it may be a problem in Denmark because of all that bacon. And the Dutch are into weed - purely mental weed that is.
 
Invisible Woman said:
This is what worries me about the NICE guideline review. It could so easily go the wrong way.....
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It could but there is no evidence for MUS no science to back it up so I think they won't go that direction. But expect them to slip in a MUS guideline which is contradictory to the ME one but claims the same space. (Have they already started on that?). I'm saying slip in because they will hope to form their own 'committee of friends and believers' as its the only way they can get away with the lack of evidence in their argument.
 
Invisible Woman said:
I hope you're right @Adrian .... I'm not sure lack of evidence will stop 'em if they think they can get away with it.

We will need to watch for slyly crafted language that is open to interpretation ....
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My assumption is that they are scared of their work being ripped apart by patients in the same way PACE was. But they may feel they can get away with it.
 
Sean said:
I have a bad feeling about this.

The medical profession in the UK increasingly looks like a cult, and that never ends well.

No disrespect to those in it trying to do the right thing.
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It does feel like the whole project is too big to fail. So many of the people whose job it is to call 'bullshit' are mixed up in it, and so many outsiders don't want the career risk of being involved in 'controversy'.
 
It is unspeakably insane the way the so-called "medically unexplained symptoms" construct blames the sufferer for the failings of current medical sciences.

How is this even a Thing? How are there enough people to give it traction?

You'd think sensible people would shy away from furthering this crazy charade, but...sigh.
 
The whole UK establishment has been co-opted, compromised, and corrupted by this appalling nonsense, sometimes willingly, and allowed it to become firmly embedded at the core of governance.

Almost none of them come out of this looking good, and the whole outfit is obviously unfit for its alleged intended purpose.

Hence, of course, they are all very reluctant to admit what has occurred under their watch.

God forbid the ruling class should be seen to have failed their noblesse oblige. Imagine what the ungrateful peasants will think of them. :nailbiting:
 
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