Let’s end the stigma of psychosomatic illness The Times (London) 22/04/2021

Jon Stone and Suzanne O'Sullivan... I wonder where I've seen those names before?

 

Got it! It's from here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)08320-2/fulltext

That's about a third, and Sharpe so loves his rules of thirds.

I say Sharpe, but this has got SMC/W3ss3ly written all over it!

 

Nah. It's not a valid construct so actually let's end it altogether. The people behind this are not serious and make absurd claims and assertions without any evidence whatsoever. And they have to use blatant lies such as asserting, without evidence, that 1/3 of patients have psychosomatic illness because of the simple algorithm where a cause must be easy to identify otherwise it's psychosomatic. This is not even close to be a valid process.

If anything, safeguards need to be implemented ASAP to prevent this nonsense from doing more harm. If they want it to be official, rather than off the record as it currently mostly is, then due process is needed, which is obviously not possible here.

And then there's stuff like this:

"Culture" does not demand that. Medicine does. Quit making stuff up.

 

This looked so bizarre I had to at least glance at the paper. Technically somatic means body, hence physical, but they are playing loose with terminology and mean functional somatic syndromes, but then use the term somatic. They also fail to be clear that diabetes is a functional syndrome in large part, as the functions involving sugar, fat and hormone issues are disturbed. I also noticed that PMS has snuck back in after failing to get its own DSM diagnostic code (unless it happened and I did not notice). What is the point of diagnoses if you add anything you want without evidence?

Functional somatic syndromes, or just functional syndromes, should be treated with respect, including respecting that we have basically admitted we don't know what they are. If history serves as a guide, most or all will turn out to be literal somatic diseases we just don't understand yet.

 

The idea that resistance to psychosomatic explanations for illness is due to stigma and not any legitimate reasons is such a typical argument by proponents of psychosomatic explanations.

As if it's only people not wanting to admit that their illness is caused by emotions, and nobody disbelieves in this idea because it doesn't make sense, has no scientific basis and is historically speaking, a serial failure.

It's also annoying how "psychosomatic" de facto just means unexplained.

 

Right, a great many object to the diagnoses, and the lack of good science, not the patients having problems and needing help.

 

Well, he is correct that functional illnesses, the way almost everything not known gets included in that group today, are certainly physical. He is also right that suffering from these, whatever trendy label you choose to give them, conditions are the next taboo, most doctors and people these days treat mental illness with higher level of understanding. He is also correct that a disease label and preferably proof of biological cause will buy you respect in the doctor's office. I can't read the full post, but I assume it would at some point advocate for BPS treatment approaches, etc. I'm feeling kind today so I'll give him some benefit of doubt.

 

Bingo!

 

I am not sure that that would be the source (if there really is one) since the paper talks specifically of neurological and gastroenterological outpatients. The proportion of patients presenting with symptoms for which doctors cannot find a clear explanation is higher in those two specialities than in most other s(e.g. rheumatology).

 

I know I know - they did also mention that they were US estimates - but I'm sure I've seen/heard SW or MS say something similar (involving thirds) recently - and these things tend to go round in self-reinforcing (vicious) circles.

Aha - here's neurology: https://jnnp.bmj.com/content/68/2/207 - cited by Stone here: https://jnnp.bmj.com/content/76/suppl_1/i2

 

Might be worth asking BBC Radio 4 "More or Less" (not sure when the next series is) they run a statistical fact checker - facts which are in the media and whether they're accurate.

 

The sole purpose of the Spectator is to generate hate.

 

The irony is that it isn't society in general that has such prejudice (that causes stigma), it is a subgroup of medical practitioners that perpetuates it.

 

Yes, it was Sharpe. It gets mentioned in Brian Hughes' blog :

https://thesciencebit.net/2021/04/06/choo-choo-all-aboard-the-long-covid-gravy-train/

The slide deck concerned can be found here :

https://www.swissre.com/dam/jcr:788...vid19-impacts-presentation-michael-sharpe.pdf

 

From the Interview, the quote was:

From the talk, he said (about outcomes of Long Covid):

I don't think maths is his strong point.

 

Unforuntately, this article has made it into the weekend The Press in Christchurch, NZ (in the Your Weekend insert). Under "It's all in your head". Arrghhh.
Doesn't seem to be online yet.