SITES AND USE IN NEWSLETTERS. PLEASE TWEET AND RE-TWEET ON TWITTER.
The Independent Letters.
The crucial importance of the name given to an illness. in understanding
its cause and improving chances of recovery from it, is illustrated with
sufferers of M.E. before and after Psychiatrists have re-labelled them,
both since 1988 (Holmes et al.) and as they wish to revise further in
their next Diagnostic and Statistical Manual of Mental Disorders, DSM-5.
(Lonely? Shy? Sad? Well now you're 'mentally ill', too, Independent, 10
February 2012 --
http://www.independent.co.uk/life-style/health-and-families/health-news/lonely-shy-sad-well-now-youre-mentally-ill-too-6699884.html).
Before: Patient has Myalgic Encephalomyelitis, as recognised in the
World Health Organisation Handbook (Issue ICD-10, 2010, Category G93.3,
"Other disorders of the brain" NOT a fatigue syndrome. F48.0, in
"Neurotic, stress-related and somatoform disorders"), which suggests
different treatments for M.E and Chronic Fatigue Syndromes. Onset of
M.E. was viral infection OR adverse reaction to vaccination; patient is
not malingering, previous good attendance work/school; not
hypochondriacal; no previous personal or family history of mental
illness. More biomedical research needed. Meantime, treatment options:
Patient experience and research evidence (Twisk& Maes, 2009) suggests
that Cognitive Behaviour Therapy (CBT) is disappointingly ineffective
and Graded Exercise Therapy (GET), makes a majority worse, some
irrecoverably so. Alternative and radical, unproven, treatments given
by unregulated charlatans are expensive and raise false hopes and even
may be the last straw that has led to suicide attempts. Low spirits, due
to social isolation, unemployment, poverty and fractured relationships
should not be confused with depression; therefore antidepressants will
not help and may cause addiction. Best options: treat any symptoms, such
as pain, sleep problems etc; demonstrate belief in illness; support in
benefits and welfare claims; visit at home when house or bed bound.
Encourage patients' enquiries and discussion of latest biomedical
research findings. Support blood and tissue bank initiatives. In event
of death, encourage post mortem and, especially, call for investigation
of inflammation in areas found in others who died after having M.E.
After: Chronic Fatigue Syndrome is now preferred term. Discourage
patient using M.E, as if more serious medical condition. Even if onset
is organic, illness is maintained by faulty beliefs (somatisation).
Treat all with CBT and GET. Encourage patients to try other treatments,
suggest can do no harm. Psychological effects are depression, therefore,
treat with antidepressants even if addictive. Encourage back to work,
even if there are relapses due to trying; do not support for
unemployment or disability benefits. Discourage patients' own research
and questions. If patient resists voluntary treatments, threaten
compulsory; if persistent, send people to break down door and section
under Mental Health Act. After death, discourage need for post mortem.
Encourage more research into behavioural management of chronic fatigue
illnesses and expansion of service to provide above treatments.
Independent journalists may be shocked if they were to enquire into the
numbers of people who have been and who are currently affected by these
practices. It is why hundreds of thousands of people in the UK, millions
around the world, remain ill and neglected with this dreadfully
disabling neurological illness, which should be treated discretely as
M.E. and not part of a fatigue bundle.
Yours sincerely
drjohngreensmith@mecommunitytrust.org
Dr John H Greensmith
M.E Community Trust.org
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