MUS services in UK and other MUS related issues

Maybe.

I actually hope that it's driven merely by the idea that it saves money as that can be argued against realistically. But I have some niggling sense that there is more to it and that reasonable debate will not move the opinions at all.

And how do they get so many people to believe something about the nature of MUS that is so at odds with reality?

 

Eventually the numbers are going to come out and they will fall very short of the absurd promised 50% "recovery", even with the usual dumbing down, cherry-picking and redefinitions of common terms they managed to make standard in psychosocial research.

Overpromise, fail to deliver. That's a combination that inevitably crumbles under its own weight. The only question is how much resources and lives they waste until reality catches up to their pipe dream.

There was no cost saving, only the delusion of. Like cutting taxes and claiming it will raise revenue. Numbers can be kept hidden for a while and bad news dismissed as fake and incomplete, but only for so long. This would probably be discussed much more if it wasn't for the trashing T-Rexit occupying all the political mental space in the UK.

 

The idea that the mind can magically cure illness is really, really intoxicating to some. It's like The One Ring or the Philosopher's Stone. Magical thinking is still common, even in highly educated professionals. It's hard to let go of this, it promises too much (which is the first clue that it's too good to be true but that rarely stops anyone).

 

EAPM2019 19-22 June, Rotterdam

7th annual scientific conference of the European Association of Psychosomatic Medicine • EAPM •
Integrating psychosomatic care across medical settings and specialties Rotterdam (The Netherlands),
19 - 22 juni 2019 Postillion Convention Centre WTC Rotterdam

Full programme PDF: https://www.eapm2019.com/stream/eapm-2019-programma-boek-versie-16-6-def2.pdf


Keynote lecture: The psychosomatic dream of integrated mental and physical care: only a dream? M. Sharpe (Oxford, UK); Andreas Schröder; Richard D. Lane, M.D., Ph.D. https://www.eapm2019.com/cms/showpage.aspx?id=3888

Program: https://www.eapm2019.com/website/program/program

Wed June 19: https://www.eapm2019.com/website/program/preconference/joint-aclp-eapm-preconference-on-pathophysiological-considerations-in-psychosomatic-medicine

Thurs June 20: https://www.eapm2019.com/website/program/thursday/eapm-main-conference-thursday-june-20th-2019

Fri June 21: https://www.eapm2019.com/website/program/friday/eapm-main-conference-friday-june-21st-2019

Sat June 22: https://www.eapm2019.com/website/program/saturday/eapm-main-conference-saturday-june-22nd-2019

Research lecture: A European research agenda for Somatic Symptom Disorders(SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) on behalf of EAPM: where do we go from here?

 

This year's Allison Creed Award Winner is Else Guthrie (Leeds, UK) Design of randomised controlled trials of interventions for people with persistent physical symptoms.

Previous Allison Creed Awards have been presented to Michael Sharpe and Per Fink.

(Allison Creed is the late wife of Emeritus Prof Francis Creed. Prof Creed was a key member of the ICD Revision S3DWG subworking group that developed the ICD-11 Bodily distress disorder diagnostic category; Prof Creed had also been a member of the DSM-5 SSD Work Group and former member of the editorial board of the Journal of Psychosomatic Research.)

The Journal of Psychosomatic Research is the publishing organ of the EAMP (European Association of Psychosomatic Medicine) that is hosting this symposium.


Although he had been a member of the DSM-5 SSD Work Group, Prof Creed does not like the SSD term or the SSD construct, himself; he prefers the Fink et al (2010) BDS construct and the name "Bodily distress disorder" or "Bodily distress syndrome". But the BDD construct that ICD-11 has developed is closely aligned to DSM-5's SSD, which must be a great disappointment to Creed.

I suspect it is largely Creed's influence that drove the (now sunsetted) ICD-11 S3DWG subworking group to persist with the "BDD" name despite the fact that as described and characterized for ICD-11, BDD has greater conceptual alignment with the DSM-5 SSD construct, but is re-purposing a disorder name historically closely associated with a differently conceptualized diagnostic construct.

May 6, 2019:

World Psychiatry

https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20635

Fuss, J. , Lemay, K. , Stein, D. J., Briken, P. , Jakob, R. , Reed, G. M. and Kogan, C. S. (2019)
Public stakeholders’ comments on ICD‐11 chapters related to mental and sexual health. World Psychiatry
18: 233-235. doi:10.1002/wps.20635 https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20635

"A majority of submissions regarding bodily distress disorder were critical, but were often made by the same individuals (N=8). Criticism mainly focused on conceptualization (48%; κ=0.64) and the disorder name (43%; κ=0.91).
Use of a diagnostic term that is closely associated with the differently conceptualized bodily distress syndrome5 was seen as problematic. One criticism was that the definition relies too heavily on the subjective clinical decision that patients’ attention directed towards bodily symptoms is “excessive”. A number of comments (17%; κ=0.62) expressed concern that this would lead to patients being classified as mentally disordered and preclude them from receiving appropriate biologically‐oriented care. Some contributors submitted proposals for changes to the definition (30%; κ=0.89). Others opposed inclusion of the disorder altogether (26%; κ=0.88), while no submission (κ=1) expressed support for inclusion. The WHO decided to retain bodily distress disorder as a diagnostic category6 and addressed concerns by requiring in the CDDG* the presence of additional features, such as significant functional impairment."​

*The CDDG is the Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD‐11 Mental, Behavioural and Neurodevelopmental Disorders (the ICD-11 equivalent of ICD-10's "Blue Book"). It hasn't been released yet, although I have had sight of a 2016 draft.

The CDDG guidelines expand on the brief Description texts in the ICD-11 MMS and include the "Essential (Required) Features, Boundaries with Other Disorders and Normality, Additional Features sections, Culture-Related Features."

[Edited to expand extract.]

 

IAPT, PPS, MUS services (UK); FDs, BDS (Denmark and beyond); EURONET-SOMA* (European Network to improve diagnostic, treatment and health care for patients with persistent somatic symptoms); Sharpe et al...like trying to hold back the tide.

I note some U.S. academics asserting on Twitter that the tide is beginning to turn in the UK and EU; I see no concrete evidence that things are improving.

*EURONET-SOMA
https://www.euronet-soma.eu/information/about-euronet-soma/

 

More like a nightmare. The idea of mixing together two mutually exclusive concepts, one literally defined by the absence of the other, is completely insane.

It seems that a good guide for competent and humane health care is basically to reject everything Michael Sharpe thinks is a good idea. The man has a natural talent for being wrong about the most fundamental things, it's almost supernatural.

 

This sounds a lot like some new age, alternative health guru.

 

I wonder what MS's definition of disease is? Does anyone know? Does he have an internal scale that weighs up a patient with tuberculosis and another having a heart attack and decides the patient with TB is more "real"?

 

This word salad is the incoherent ramblings of a very confused mind. WTH is wrong that this mad-hatter is taken seriously? He should be a patient of his own nonsense, not in a position of authority to promote weird snake oil. Shame on anyone who takes this guy seriously. You should know better.

 

Once in an interview Peter Ustinov described the pleasure of playing his part in The Pink Panther film. It includes the phrase 'I love the idea of a man who aims low - and misses.'

 

Topaki.

Peter Sellers did the Pink Panther series. Ustinov was in Topaki when that line was used.

 

Yes, I think it was Topkapi. It was about the emerald heist.

 

It seems that back in the day, ideas weren't tested to see if they are correct, they were simply asserted to be correct. Sharpe and colleagues continue this tradition.