Review The role of psychiatry in diagnosis and treatment of paediatric chronic fatigue syndrome – a scoping literature review, 2023, Dolp et al

Andy

Andy

Retired committee member
Objectives

Paediatric Chronic Fatigue Syndrome (pCFS) is a common condition that significantly disrupts a healthy psychosocial development. Psychiatric symptoms associated with pCFS are conceptualized as either part of its complex etiology, its consequence, or as a comorbidity. However, patients with this condition are rarely seen by psychiatrists. This scoping review aims to explore the role of psychiatry in the diagnosis and treatment of pCFS.

Content
A scoping review of literature was conducted using MEDLINE, EMBASE, Cochrane and PsycINFO. Databases were searched for articles describing psychiatric involvement in the diagnosis or treatment of children and adolescents (age ≤ 18) with pCFS. A grey literature search was also conducted to identify additional guidelines and national recommendations to identify the role of psychiatry in the diagnosis and treatment of pCFS.

Summary
The search provided 436 articles of which 16 met inclusion criteria. Grey literature search identified 12 relevant guidelines. Most studies and guidelines did not include any psychiatric involvement in the care of patients with pCFS. If psychiatry was mentioned, it was used interchangeably with psychological interventions or in the context of treating distinct psychiatric comorbidities and suicidal ideation.

Outlook
The role of psychiatry in diagnosis and treatment of pCFS is poorly defined. Future research is required to understand how psychiatrists can contribute to the care of patients with pCFS.

Paywall, https://www.degruyter.com/document/doi/10.1515/ijamh-2023-0030/html
 
Abstract said:
Paediatric Chronic Fatigue Syndrome (pCFS) is a common condition that significantly disrupts a healthy psychosocial development.
...
Most studies and guidelines did not include any psychiatric involvement in the care of patients with pCFS
...
Future research is required to understand how psychiatrists can contribute to the care of patients with pCFS.
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Ugh. An awful lot of assumptions there.

The 3 authors are at the Department of Psychiatry, Queen’s University, Kingston, ON, Canada
 
Interesting the authors are saying this is a common condition.

I'd have to review numbers, but my recall is CFS for any age category is not officially defined as common.

Maybe, just maybe, if "CFS" was officially defined as "common", there would be more biomedical research funding for it. And, there might be appropriate medical education on it, effective treatment, etc.

Other than that, my comment on the idea of increasing psychiatry's involvement in kids' CFS is oh, deliver me!
 
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The paper said:
If psychiatry was mentioned, it was used interchangeably with psychological interventions or in the context of treating distinct psychiatric comorbidities and suicidal ideation
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Again comes down to the definition of what psychiatric means, besides involving psychiatrists. Because it is fully interchangeable here. When limiting strictly to psychosocial fluff, there is no actual difference, psychiatric and psychological have roughly the same meaning. And neither have a place anyway, they don't even know what they're supposed to do, yet imagine that they must. In part because no one else is, but that's entirely their fault so their involvement is fully circular, bootstrapped.

What is very obvious is that having historically dominated this issue, psychiatry is formally in charge, but has no clue what to do with it. You can involve psychiatrists if you want, but they wouldn't do anything different than someone who was handed a simple CBT certificate 2 weeks before following a week-end crash course. The sum total of their knowledge about us fits on a one page pamphlet. Literally. You can use big fonts, too.

Basically, psychiatry broke and bought chronic illness. It's theirs. And they have no idea what to do next, like the dog that caught the car and can only think about chasing the next car. Always chasing the next car. For decades, while people's lives are ruined. Always developing novel identical "programs".
 
rvallee said:
they don't even know what they're supposed to do, yet imagine that they must.
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It's a lot like astrology: someone decided that the stars must have some influence on our lives, and created a nonsensical belief that is still going strong., despite a lack of evidence to support its claims. I think what they have in common is a promise of magical benefits. People want to believe in simple, easy ways to improve their lives, rather than accept reality. Governments also want to believe in easy cheap solutions to expensive problems, such as diseases and mental disorders, and the system is set up so that the people who set up a program, such as GET, reap career rewards, and aren't punished when the program fails (the smart people move on before that happens).
 
Sly Saint said:
Most, if not all, of Crawleys papers say CFS is a 'common condition'.
(5 of the 16 articles in 'references' are Crawley papers, which is not surprising as she has been regarded as 'the expert' on paediatric CFS for quite some time.)
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Thanks @Sly Saint

Of course (!), this declaration "cfs" is common is what the BPS Movement has aimed for, in designating ""cfs" a psychiatric condition. As in lots of people are tired, anxious and depressed from time to time. So, everyone can occasionally feel this way.

The BPS group would say it's just that some people incorrectly believe being tired, anxious and depressed is a distinct disease, called "cfs" or ME.

This despite increasing evidence, ME is a distinct biomedical disease.


Thanks again.
Cheers.
 
RedFox said:
No, ME is both a distinct disease and common. The CDC considers a disease that affects more than 200,000 Americans to be common, and ME is estimated to affect at least 835,000.
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Thanks for this stat, @RedFox

So, ME is common!

(My recall is seeing percentages, but not seeing anything about where the benchmark is for defining ME as common.)
 
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