Health Care Use and Costs of Children, Adolescents, and Young Adults With Somatic Symptom and Related Disorders, 2020, Saunders et al

Open access, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768569

 

It’s Time to View Severe Medically Unexplained Symptoms as Red-Flag Symptoms of Depression and Anxiety

Open access, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768562

 

I can't get my head round this sort of mind set. If children have a set of symptoms they need investigated. If all the wrong tests are used it will be more expensive and take longer. Looking in the wrong place will never find an answer.

The answer could just as easily lie in the diagnostic process as with mental health issues in the patient. Byron Hyde described a young patient who had blisters on her hands and in her mouth. Now I am a lay person but my next move would have been to check her feet. Instead they decided she was deliberately damaging her mouth.

Part of this is that GPs are the experts in common diseases and would have recognized hand foot and mouth disease but the hospital doctors did not. Yet enteroviruses are known to cause serious body wide disease in some children, from polio to AFM. A quick look under the covers would have ruled it in or out.

That sort of diagnostic failure is widespread and would be a better place to look than introducing psychological treatments which have a very low success rate.

I was very impressed by the paper that said mental health diagnoses should have the same level of evidence as physical diseases. Not a lot to ask.

 

Did not Abbey, one of the sources of our woes, hail from Toronto General Hospital. So this should come as no surprise.

 

Anyone who guessed that Robert C Smith MD is a very old white man is correct:

https://www.psychologytoday.com/au/experts/robert-c-smith-md

http://www.im.msu.edu/for applicants section/key faculty profiles/key faculty cvs/smith_cv.PDF (BS 1959, MD 1962)

"Establishing the Scientific Validation of the Biopsychosocial Model of Care" lecture:

https://www.youtube.com/watch?v=rmvN3Rutq2U

"The Biopsychosocial Revolution" (2002):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495036/

 

Wait, sick people seek medical care? Get out of here. That can't possibly be true, we all know that genuinely sick people don't ever do that so it's certainly right to label them as imaginary illness. QED.

I am absolutely disgusted by the people who work on this. These are children and they toy with their lives for a mediocre ideology. Medicine priding themselves on not participating in legally-sanctioned executions means nothing when they do grotesquely evil stuff like that, mentally torturing sick children. Morally this isn't any different than societies that performed ritual sacrifices. Instead of a Sun god it's the conversion disorder ideology, which frankly makes it worse considering the context.

This whole thing is genuinely the Platonic ideal of the road to hell being paved with good intentions. They think they're helping even as they are mentally and physically torturing sick children, patting themselves on the back for a job well done of... not helping whatsoever given that these sick children continue to do the thing this rotten ideology is trying to avoid: seeking medical care. This is literally spending money to hurt people while refusing to spend the necessary money to actually help them.

I have no idea what that's doing here, there is no such thing as physician-delivered mental health care because it would not even be authorized or reimbursed by the national insurance system, there is a strong split between mental health and the rest of health care. There is no parity of care in large part because mental health care is so primitive as to be barbaric.

 

That's usually the step that happens long before putting something into practice. Literally step 1 of many.

Usually. In serious professions anyway.

 

That's horrifying coming from Sick Kids hospital, U of T (various dept's), and the centre for addiction and mental health.

It's very probable to me that people with unidentifiable health issues toss up on the steps of CAMH because their lives have been adversely impacted and they're struggling but that doesn't mean their primary / sole issue is depression or anxiety. Or even an issue at all.

@chrisb Who's Abbey?

Also, just want to alert @ScottTriGuy

 

She was, or may still be, a psychiatrist who played a prominent part in the CIBA conference andwho held strange views on somatisation. I did not think this too important until seeing in Oslers WEb that she was involved in CDC committees that scuppered various research plans. See

Somatisation, illness attribution and the sociocultural psychiatry of chronic fatigue syndrome
Susan E Abbey 1993 Chronic fatigue syndrome, Wiley, Chichester (Ciba Foundation Symposium 1730 p238-261

if you are feeling strong enough.

And she edited a book for US practitioners with Demitrack which allowed Straus to wholly misrepresent the findings of a paper by White, notwithstanding that she referred correctly to the paper in her own chapter.

 

@chrisb

Thanks for your response. I'd truly never heard of her before in anything I've read about ME.

I'm unable to do any indepth reading but I found the book you refer to.

 

Worrying i.e. MUS - https://www.dvhn.nl/groningen/Als-d...Q6BpGgZYj12PDwNlzO3wTT9slV8VEbM22MjpV3xmpWudA

@Michiel Tack

 

The research article by Saunders is about "Somatic symptom and related disorders (SSRDs)". The article explains this category as follows.

Don't quite understand why they include fibromyalgia, IBS and CFS in this.

 

The comment by Smith reads:

Which made me think: in what way are depression and anxiety better-validated disorders than ME/CFS?