PPS new name for MUS - Integrated Care for People with Persistent Physical Symptoms 02/10/2018

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Event in October this year:
"
Event Details
The words ‘Integrated Care’ currently feature in every health briefing, newsletter and policy document, but what exactly does it mean and what does it look like in practice? For people with Persistent Physical Symptoms as a result of a long term conditions and/or disturbance of function, treating physical, psychological and social needs in tandem is key to getting the best outcomes in terms of morbidity, mortality, quality of life and cost.

This event, sponsored by the Academic Health Science Network on behalf of the Integrated Care System, proposed a region-wide model of care for people with Persistent Physical Symptoms."

Includes various workshops including:

"Findings from Research Working with General Practice to Improve Pathways for People with Persistent Physical Symptoms
  • Prof. Vincent Deary, Professor of Applied Health Psychology, Northumbria University and Joanne Smithson, Programme Lead, AHSN NENC"

PPS seems to be another name for MUS.

http://www.ahsn-nenc.org.uk/event/integrated-care-for-people-with-persistent-physical-symptoms/

it was covered on Twitter https://twitter.com/search?q=#PPSNENC&src=typd

Julia Newton was involved; why?

see also:
"Improving care pathways for people with Persistent Physical Symptoms
Dr Vincent Deary, Joanne Smithson, Dr Michaela Faye. (Northumbria University Newcastle)

"Our work is focusing on three PPS: Chronic Fatigue Syndrome (CFS),
Irritable Bowel Syndrome (IBS) and Fibromyalgia."

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=15&cad=rja&uact=8&ved=2ahUKEwiI_aOT0dbeAhUJYlAKHcRrBxE4ChAWMAR6BAgFEAI&url=https://www.rcplondon.ac.uk/file/2177/download?token=bkPZFopc&usg=AOvVaw1CHuPVivGuT4AyJ3FVnw3o

Vincent Deary also contributed a couple of chapters to ABC of MUS and in this:
https://uclhgptrainers.files.wordpr...ed-to-talk-about-symptons-an-introduction.pdf
thanks Chris Burton for his contribution.
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pteropus said:
i'm waiting for the peak-farcical moment when broken legs (and every other human injury / disease) are treated with online CBT.
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I have said before they should bring CBT to funeral homes and morgues. I mean the kind of CBT they propose for ME and CFS is basically magic, how is that different from Voodoo? Let them raise the dead, then all those pesky life assurance claims can be put aside. If anyone is unsure, yes this is a satirical comment.
 
I, for one, suggest the far more useful diagnostic criterion of PBS: persistent bullshit syndrome. Or its cousin diagnosis of SAS: shifting acronym syndrome.

It's a disease characterized by projecting motive and intent onto patients in a framework of unhelpful illness beliefs on the part of the therapist.

It's unfalsifiable, allowing the therapist to constantly shift and morph their own beliefs onto the diagnosis, and provides a steady stream of income for those unable to perform actual scientific research or useful clinical work.

Recommended reading includes studies of prophesizers and their shameless ability to be 100% confident of every new variation of the same predictions.
 
This is getting ridiculous. It should be viewed as ridiculous.

What are they aiming at? It is known there are dumb people, but I very much doubt these people don't know their own concepts (FSS, BDD, BDS, MUS, FND etc., now PPS), and I doubt there is no agenda. What's the agenda? Do they want to create so much confusion that people don't even try to understand and "trust" these "experts" know? Or do they only want to look like experts?
 
Inara said:
This is getting ridiculous. It should be viewed as ridiculous.

What are they aiming at? It is known there are dumb people, but I very much doubt these people don't know their own concepts (FSS, BDD, BDS, MUS, FND etc., now PPS), and I doubt there is no agenda. What's the agenda? Do they want to create so much confusion that people don't even try to understand and "trust" these "experts" know? Or do they only want to look like experts?
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From what I have read I think they 'created' PPS as they thought it would be 'more acceptable' to patients than MUS, MUPs.
The ultimate aim, I guess, is to save money, under the guise of 'Integrated Care'. Unfortunately, what they don't seem to realise is this will just lead to diluted/ineffective treatment for a large number of patients. What is needed is more specialist care.

They are learning this (although you would have thought it would be obvious) the hard way with Mental Health and the IAPT approach which is proving to be totally cost ineffective.
 
rvallee said:
I, for one, suggest the far more useful diagnostic criterion of PBS: persistent bullshit syndrome. Or its cousin diagnosis of SAS: shifting acronym syndrome.

It's a disease characterized by projecting motive and intent onto patients in a framework of unhelpful illness beliefs on the part of the therapist.

It's unfalsifiable, allowing the therapist to constantly shift and morph their own beliefs onto the diagnosis, and provides a steady stream of income for those unable to perform actual scientific research or useful clinical work.

Recommended reading includes studies of prophesizers and their shameless ability to be 100% confident of every new variation of the same predictions.
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Utter Tripe Syndrome :sneaky:
 
alex3619 said:
Its not just diagnoses. Look at PACE. Meanings change. Recovery that overlaps with serious disability. Pacing that is not pacing. Normal that is highly abnormal and wrong. They play with language and hope nobody notices.
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Thats a house of cards, yet another reality denying tactic among so many.
We need to give up the lies to make progress because reality is a cruel mistress.
 
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alex3619 said:
There is a saying, attributed to Philip K Dick, that reality is that which, when you stop believing in it, doesn't go away.
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Interesting. I view it pragmatically, reality denial leads us away from actually solving problems by pretending cold hard facts are too much to bear
 
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For interest, I had a bit of a Google to see what early references I could find on the exact term, 'persistent physical symptoms'. I'm sure it can be traced back further, but the earliest references I've encountered so far online are found in a couple of late 90's publications co-authored by a Charles C. Engel, who has a military psych background, a document of Congress hearing on GWI healthcare (for which hearing Charles Engel was a witness), and a paediatric anxiety scale (July 1997).

Another American Engel, George Libman Engel, who was also based out of the East Coast, was the originator of the biopsychosocial model of health and illness (1977).

VA'S Health Care Treatment for Persian Gulf War Illnesses, Hearing before the subcommittee on health of the committee on veterans' affairs - House of Representatives One hundred Fifth Congress First Session, 19 June 1997
https://www.gpo.gov/fdsys/pkg/CHRG-105hhrg44671/pdf/CHRG-105hhrg44671.pdf
Major ENGEL.
Well, I can't speak to the VA. I certainly can speak to healthcare in general. I think that this subset of patients with persistent, unexplained symptoms tend to be in "No Persons Land," that psychiatrists historically fmd them somewhat frustrating in that the patients don't want to talk about the emotional aspects of their difficulty, and internists find them difficult because they are trained to look at what is the right diagnostic test and what is the result, and they don't get satisfying results from the diagnostic test, and that is part of the problem. I think sometimes physicians, out of frustration, as they attempt to define cause or diagnosis, will say things to patients that maybe even they don't really think, but they feel stymied in this attempt, just as the patient does, to come up with a cause or diagnosis.
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The precise term, PPS, isn't used by Engel in the quoted text, but is used elsewhere.

Multidisciplinary Treatment of Persistent Symptoms after Gulf War Service
Maj Charles C Engel Jr; Maj Michael Roy; LtC Daniel Kayanan; Col Robert Ursano
Military Medicine, 163, 4:202, 1998
https://tinyurl.com/ydakxlvs

Appendix A: Population and Need-Based Prevention of Unexplained Physical Symptoms in the Community
Charles C. Engel, Jr., and Wayne J. Katon
Strategies to Protect the Health of Deployed U.S. Forces, Editors: Lois M. Joellenbeck, Philip K. Russell, and Samuel B. Guze.
1999, Institute of Medicine (US) Medical Follow-Up Agency
https://www.ncbi.nlm.nih.gov/books/NBK225085/

Charles C. Engel:

https://www.rand.org/about/people/e/engel_charles_c.html

https://www.researchgate.net/profile/Charles_Engel/2

George Engel:

https://en.wikipedia.org/wiki/George_L._Engel

Children's anxiety rating scale:
https://tinyurl.com/ycxjtny7
 
Sly Saint said:
From what I have read I think they 'created' PPS as they thought it would be 'more acceptable' to patients than MUS, MUPs.
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There's also researchers' ego at play. Deary favors PPS, and he pushes for its use, Per Fink has his Bodily distress disorder (or something approaching), Jon Stone states that "functional" is the best term, because it is more accepted by patients, John Sarno called unexplained pain TMS (Tension myositis syndrome).
Pathetic race.
 
rvallee said:
Or its cousin diagnosis of SAS: shifting acronym syndrome.
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:D thank you for that much needed giggle @rvallee


rvallee said:
It's a disease characterized by projecting motive and intent onto patients in a framework of unhelpful illness beliefs on the part of the therapist.

It's unfalsifiable, allowing the therapist to constantly shift and morph their own beliefs onto the diagnosis, and provides a steady stream of income for those unable to perform actual scientific research or useful clinical work.

Recommended reading includes studies of prophesizers and their shameless ability to be 100% confident of every new variation of the same predictions
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Exactly.


alex3619 said:
Its not just diagnoses. Look at PACE. Meanings change. Recovery that overlaps with serious disability. Pacing that is not pacing. Normal that is highly abnormal and wrong. They play with language and hope nobody notices
Click to expand...

War is peace
Freedom is slavery
Ignorance is strength
 
Chalder has contributed a chapter on MUS in the latest edition of this book (Nov 2018)
The Therapeutic Relationship in Cognitive Behavioural Therapy

8. Medically Unexplained Symptoms David McCormack & Trudie Chadler


They try explain why they now apparently prefer PPS to MUS
upload_2018-12-2_12-37-44.png



upload_2018-12-2_12-45-2.png


https://uk.sagepub.com/en-gb/eur/th...itive-behavioural-therapy/book257330#contents

so we also now have PUS (persistent and unexplained symptoms) or UPS(?)

eta: I only read a couple of pages but looks like this entire chapter is viewable on Google books
 
Sly Saint said:
Chalder has contributed a chapter on MUS in the latest edition of this book (Nov 2018)
The Therapeutic Relationship in Cognitive Behavioural Therapy

8. Medically Unexplained Symptoms David McCormack & Trudie Chadler


They try explain why they now apparently prefer PPS to MUS
View attachment 5008



View attachment 5009


https://uk.sagepub.com/en-gb/eur/th...itive-behavioural-therapy/book257330#contents

so we also now have PUS (persistent and unexplained symptoms) or UPS(?)

eta: I only read a couple of pages but looks like this entire chapter is viewable on Google books
Click to expand...

moving_goalposts.exe running
 
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