UK: NHS East London: Medically Unexplained Symptoms/ Bodily Distress Disorder Service

Sly Saint

Sly Saint

Senior Member (Voting Rights)
What is the Bodily Distress Disorder Service?
One-Stop-Shop
The Bodily Distress Disorder (BDD) Wellbeing Service offers a “One-Stop-Shop” service with a choice of group treatments (online or face-face) – Meditation Based Stress Reduction (MBSR) and Strategies for Healthy Living Group (SHLG), Body- Oriented Therapy.

These targeted group therapies have been developed and evaluated through research to improve enduring physical symptoms, working with and through embodiment and the focus is on improving physical, mental and emotional wellbeing.
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“This innovative project works directly with and through patient’s bodily complaints demonstrating that a flexible, patient-oriented approach to MUS/BDD can make a real difference”

Dr Frank Röhricht, Project Lead
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https://www.elft.nhs.uk/medically-unexplained-symptoms-bodily-distress-disorder
 
I love the way they’ve incorporated traditional therapy language, ancient spiritual traditions and radical advocate terminology into their exploitative, self-interested and patient blaming endeavours.
 
These targeted group therapies have been developed and evaluated through research to improve enduring physical symptoms
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It's technically true that they have been developed and evaluated. They have also been found to be useless at it, especially as all the evidence insists that it's about coping/managing, so there can be no actual language pretending there is evidence for treating symptoms. But of course in clinical settings it's always distorted into, uh, "improving", is what they're going with? Whatever.

Damn, so really Long Covid will have made zero difference, maybe other than injecting more money into this pseudoscience. Damn do we badly need medical AIs to get out of this mess, the humans really are not up for it. And I guess MUS is now an exact synonym, official, for BDD. Which means the same thing. The same as the dozens of other acronyms they use for the exact same definition. Damn these people are weird.
 
Was this the pilot (2012-2013):


mus-pilot.png


PDF: PILOT OF ENHANCED GP MANAGEMENT OF PATIENTS WITH MEDICALLY UNEXPLAINED SYMPTOMS

https://www.kingsfund.org.uk/sites/...lly-unexplained-sympthoms-kingsfund-may12.pdf


PDF: Guidance for health professionals on medically unexplained symptoms (MUS)

https://dxrevisionwatch.files.wordp...-for-health-professionals-on-mus-jan-2011.pdf


Note that SNOMED CT UK edition already includes the ICD-11 term Bodily distress disorder (with Somatic symptom disorder under Synonyms), although ICD-11 is not yet adopted for use in England and won't be for a number of years.

There is a different code which is exclusive to the SNOMED CT UK edition for Medically unexplained symptoms.

Note also that for ICD-11, the three terms coded at 8E49 are specified exclusions under BDD.
 
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This is the description text for ICD-11 Bodily distress disorder:

https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/767044268

Note the BDD term, as defined by WHO, can be applied as an additional diagnosis to any disease or condition:

"If another health condition is causing or contributing to the symptoms, the degree of attention is clearly excessive in relation to its nature and progression."
 
rvallee said:
It's technically true that they have been developed and evaluated. They have also been found to be useless at it, especially as all the evidence insists that it's about coping/managing, so there can be no actual language pretending there is evidence for treating symptoms. But of course in clinical settings it's always distorted into, uh, "improving", is what they're going with? Whatever.

Damn, so really Long Covid will have made zero difference, maybe other than injecting more money into this pseudoscience. Damn do we badly need medical AIs to get out of this mess, the humans really are not up for it. And I guess MUS is now an exact synonym, official, for BDD. Which means the same thing. The same as the dozens of other acronyms they use for the exact same definition. Damn these people are weird.
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And even if people do get their head around 'focusing on coping rather than looking for anything else to help', that in itself is shown up by the fact that these researchers have to lie about recovery rates/prognosis in order to coerce people 'yes that's the most sensible option dear' and block both proper research into any treatments but mainly any investigations whatsoever.

And it's a name we are all familiar is at least near-identical to where someone is unhappy with their body unduly e.g. they think they look like the elephant man when they are brad pitt. or believe they've got abnormal horrific elbows and everyone is looking at them. So that is what this bunch think is going on and they are treating

... when the para above, is what it is based on ....their convoluted personal delusions and having created a dystopia by lying and arranging all the furniture and scenery to stage that lie to be true.

I'm about to use a cliche but lunatics running the assylum has been coming to mind a lot lately and this particular school and its strange off-shoots is certainly beginning to feel like a distortion heydey from people who perhaps don't think or see the same as most for reasons that might be better tackled in ways other than handing over a kingdom of vulnerables to play with who can't escape - I mean what is the way out of this no-win if the notes and labels represent a don't touch or investigate warning?

I wouldn't be surprised if any effect was based only on the world-swallowing horror they induce in all meaning those who don't end up grabbing deluding themselves to hide temporarily as an insanity to just get away from it (like when you need a cancer biopsy but decide to get on with life for now because you can't cope with if it is what it might be) have their mental health massively damaged vs those who numb themselves and just let their answers be dictated to them short term [and then suffer even worse psychological harm and physical harm I suspect because of what was done to them by being taught to gaslight themselves]. There is very rarely a finding based on the actual function improving or a symptom going away, it is all enforced bravado based on 'perceive I can cope better'.
 
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Sly Saint said:
https://www.elft.nhs.uk/medically-unexplained-symptoms-bodily-distress-disorder
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Do meditation that isn't proven to reduce stress, get lectured on to 'live better' without it sounds anything that makes that more possible (little evidence except maybe a select few targeted programmes where it is very specialist, non-psych for very specific conditions/situations being tackled, but even then they tend to be using e.g. groups and notes to allow people to attend or provide them with access to things they didn't have before), gaslighting assuming/telling them they are 'imagining it/overthinking/not in that much pain' and any other disability trope one might care to insert.

Isn't this just misogyny + disability bigotry 101? Particularly when it sounds like 'don't let them pass go or take £200' (a phrase from the game Monopoly) just select by demographic or your 'gut instinct' and send right here - it is therefore pure discrimination and bigotry and cutting out access to healthcare and forcing into loss of freedoms based on their gender, age or symptom or don't like look of their face? Alongside insinuations and blacklisting to make sure these individuals don't have access to being heard as a truthful witness or have their real problem ever uncovered as something different. Certainly not in a timeframe that matters. I'm not sure there is a worse crime against anyone that a human could do when you add up the cumulative implications of this 'now habitual wraparound package of horror'.

Because let's be honest what they are really giving out is a nasty little 'don't touch, listen or care' stamp to ensure that these people are blacklisted from medical and other services.

They can hide it with distraction spiel pretending its all this useless - even if it was any of these things - nonsense that some people are making a nice little gravy train from (and so will fight for it to never be dropped), but let's start noting what they are really doing: Diverting out of any service, any service medically that will look at anything long-term. No clinic that will do follow-up and be honest about that (because this lot won't admit their own eyes if someone ends up with lumps on their joints or if someone stops being able to speak or eat they delude themselves it's 'a behavioural reaction' it is madness).

You'd think in any normal country there would be a strong legal network that had nothing to do with/Chinese wall from these 'conflicts of interest individuals who've been given powers [and responsibilities they don't respect or acknowledge fully] that they shouldn't have which don't apply to those they tend to pick on (but those who are in that group don't know for sure) and so there would be a strong human right law and protectorate explicitly guarding against this obvious pathwaying out of citizenship. It looks so blatant in impact, I cannot believe all those who pretend and play along can really delude themselves any differently - they are just happily handing over others and happy of not even having to own by having words that don't make sense to pretend they don't see it?
 
Arnie Pye said:
Is it just me who finds the term "bodily distress" insulting? It's the kind of thing I think of in connection with women fainting in Victorian melodrama.
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I think they specifically use the term distress as a wind-up to be honest. A term used alongside hysteria.

To me in this context it feels like it corresponds to some doctor whispering behind the patients back about how she's getting herself worked up because her hand apparently doesn't feel the same as it used to. Doesn't feel comfortable anymore. Given when it is anything else you name the body part then the obvious emphasis is on 'distress' and locating it as 'focused on body' and the source/cause not being something specific to that body part [otherwise it would be named and you'd be sent to the hand or nerve guy?] so it is a drop-down for the psych therapist.

The problem isn't with the arm but with the person whinging about it.

And thinking yeah mate she is probably seeming 'worked up' at talking to someone who can't/won't hear and turned up having decided they don't need to and that demeanor and failing isn't a problem. And she came all the way in order to report this and is being stitched up before she entered to look silly by someone sitting there who is intent on staring in dubiousness of her veracity for no reason. And these days women, certainly those who have been in the workplace, got qualifications etc don't expect such blatant disrespect and mickey taking.

So that word is likely to cause shock just as a label when you've been told you'll get a referral to look at your increasingly debilitating wrist stiffness stopping you from typing or whatever and end up there getting told to eat more fruit (you already do, why are you assuming), be more grateful (erm why?) and shut up.

Because they won't be thinking of that as medical origins either, as they didn't ge the memo/brainwashing from 18yrs that they are supposed to be assumed as idiot plebs and the rule/pass it on came from another doctor so now it's 'medicine' not sexism/disability bigotry etc.

And yes I bet a lot of these people are inciting frustration deliberately, enjoying causing it then whether it happened or not using that to claim 'proof'. It's laziness based on covering a deficiency in too many people having given up using their ears and connecting them with their brain and thinking they can still keep their jobs as long as they play the power differential. Imagine if that was what was happenning in an organisation that did surveys, or took customer feedback properly and it was about something else so without it risking someone's treatment and all the threats putting people off - we all know about companies that can see when you've had 20 customers all tell the same tale of the same behaviour about someone and they have to be retrained or moved.

I can't help but thinking this is based on stories being sold to gatekeepers as scare tactics of 'problem patients' to send them off here so you've got them labelled before they get a chance to complain about you type thing.
 
Arnie Pye said:
Is it just me who finds the term "bodily distress" insulting? It's the kind of thing I think of in connection with women fainting in Victorian melodrama.
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I agree. It seems to be the diagnosis intended to single out people who the clinician thinks are exaggerating their symptoms, that the degree of suffering can't possibly be caused by whatever disease they have. An excuse to bundle people off to psychologists for 'therapy' so they can be taught not to trust their own experiences as real. Gaslighting.
 
About Us
Patients with Medically Unexplained Symptoms (MUS) or Body Distress Disorder (BDD) often have unmet health needs due to the complex nature of their conditions.

In 2014 East London Foundation Trust (ELFT) began looking at innovative solutions to meet the needs of these patients in Newham. Through partnerships between primary and secondary care providers — GPs and medical specialists — the project explored how to best develop an integrated care pathway across East London for patients with functional bodily distress symptoms.

Patients who took part in the project appear to have benefited from the holistic approach to care; the findings showed a reduction in the number of physical health complaints reported by patients and an improvement in the feedback given by patients relating to their quality of life.

Following this work the Trust has now been awarded further funding from the Health Foundation to enable the findings from the pilot to be shared across the wider NHS to spread improvement and support dissemination.

In 2016 there were a number of activities to share learning, knowledge and skills with clinicians, particularly staff who work in primary care settings (GPs and nurses). This includes the development of a teaching and training package for primary care providers, an information resource for commissioners and a website/ online resource for clinicians across the country who are working with patients with MUS.

The project is being led by Professor Frank Röhricht, Medical Director at the Trust who is looking to develop and support a network of interested clinical staff in order to better understand the options available to deliver a high quality and cost effective service to patients who present with MUS.
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Arnie Pye said:
Is it just me who finds the term "bodily distress" insulting? It's the kind of thing I think of in connection with women fainting in Victorian melodrama.
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It's appalling that something that should be in the DSM wound up in the ICD. It has no place at all there, and neither should any notion of any form of distress like this. The description of "clearly" is patently absurd, it's an arbitrary judgment made out of nothing at all.

And sadly there is a place for this, when it really, actually "clearly" is, but probably something like 99% of it is misused with bad intent, which makes the entire concept invalid as it cannot be used professionally.
 
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